Phenotype and biomarkers in patients who initiated biologics therapy stratified by oral corticosteroid use in the International Severe Asthma Registry

<bold>Background:</bold> Oral corticosteroids (OCS) are overused in severe asthma patients, but the profile of patients who use OCS is not sufficiently described. <bold>Aims:</bold> To compare the phenotype and biomarkers of severe asthma patients before biologic initiation by pre-biologic OCS use. <bold>Methods:</bold> This cross-sectional study used the International Severe Asthma Registry, a multinational prospective registry of asthma patients aged ≥18 years old on GINA step 4/5 therapy. Those with biologic initiation and ≥1 year of prior data were included and grouped by OCS use (non-users, intermittent users, and long-term [LTOCS] users). <bold>Results:</bold> In total, 4,305 patients were included (41% LTOCS users, 54% intermittent users, 5% non-users). Most patients had an eosinophilic phenotype and ≥1 type 2 comorbidity (Table). LTOCS users had the highest proportions of persistent airway obstruction and blood eosinophil count <150 cells/µL (Table). Long-term and intermittent OCS users had higher frequencies of uncontrolled asthma than non-users (Table). <bold>Conclusions:</bold> Most severe asthma patients had LTOCS/intermittent OCS use before initiating biologics. LTOCS users had the wort lung function, with distinct biomarker patterns. Reasons for poor asthma control in OCS users and OCS’ confounding effects on biomarkers need exploration. <fig><object-id>erj;64/suppl_68/PA438/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

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Publication Details

Journal
Epidemiology
Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa438
Primary Topic
Asthma and respiratory diseases
Type
article
Field-Weighted Citation Impact
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article

Phenotype and biomarkers in patients who initiated biologics therapy stratified by oral corticosteroid use in the International Severe Asthma Registry

Lakmini Bulathsinhala, Piotr Kuna, Martín Sívori, Carlos A. Torres-Duque et al.
Epidemiology
Asthma and respiratory diseases
article

Phenotype and biomarkers in patients who initiated biologics therapy stratified by oral corticosteroid use in the International Severe Asthma Registry

Lakmini Bulathsinhala, Piotr Kuna, Martín Sívori, Carlos A. Torres-Duque, Ruth Murray, Kirsty Fletton, Sundeep Salvi, Renaud Louis, Richard W. Costello, Dermot Ryan, Chin Kook Rhee, Libardo Jiménez-Maldonado, Zsuzsanna Csoma, Delbert R. Dorscheid, George Christoff, Désirée Larenas‐Linnemann, John Townend, Todor A. Popov, ARNAUD AB BOURDIN, Rebecca Gall, Christian Taube, Francesca Puggioni, Christine Jenkins, Alan Altraja, Celine Goh, Leif Hilding Bjermer, David Price, Stelios Loukides, Céline Bergeron, Κonstantinos Κostikas, Victoria Carter, Borja G. Cosío, Jeffrey Shi Kai Chan, Unnur Steina Björnsdóttir, Mona Sulaiman Al-Ahmad, Vidya V. Navaratnam, Paulo Márcio Pitrez, Ming‐Ju Tsai, Adeeb A. Bulkhi, Takashi Iwanaga, João Fonseca, Iván Solarte, Lauri Lehtimäki, Roy A. Pleasants, Aaron Beastall, Zhixiao Wang, Bassam Mahboub, Bernt Bøgvald Aarli, Wei‐Han Cheng, Mariko Siyue Koh, Charlotte Suppli Ulrik
article en

Abstract

<bold>Background:</bold> Oral corticosteroids (OCS) are overused in severe asthma patients, but the profile of patients who use OCS is not sufficiently described. <bold>Aims:</bold> To compare the phenotype and biomarkers of severe asthma patients before biologic initiation by pre-biologic OCS use. <bold>Methods:</bold> This cross-sectional study used the International Severe Asthma Registry, a multinational prospective registry of asthma patients aged ≥18 years old on GINA step 4/5 therapy. Those with biologic initiation and ≥1 year of prior data were included and grouped by OCS use (non-users, intermittent users, and long-term [LTOCS] users). <bold>Results:</bold> In total, 4,305 patients were included (41% LTOCS users, 54% intermittent users, 5% non-users). Most patients had an eosinophilic phenotype and ≥1 type 2 comorbidity (Table). LTOCS users had the highest proportions of persistent airway obstruction and blood eosinophil count <150 cells/µL (Table). Long-term and intermittent OCS users had higher frequencies of uncontrolled asthma than non-users (Table). <bold>Conclusions:</bold> Most severe asthma patients had LTOCS/intermittent OCS use before initiating biologics. LTOCS users had the wort lung function, with distinct biomarker patterns. Reasons for poor asthma control in OCS users and OCS’ confounding effects on biomarkers need exploration. <fig><object-id>erj;64/suppl_68/PA438/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

Epidemiology
University of North Carolina at Chapel Hill (US), Reykjavík University (IS), Dubai Health Authority (AE), Centre National de la Recherche Scientifique (FR), University of British Columbia (CA), Kaohsiung Medical University (TW), Inserm (FR), University of Liège (BE), University of Iceland (IS), The University of Western Australia (AU), University of Ioannina (GR), Université de Montpellier (FR), Umm al-Qura University (SA), National and Kapodistrian University of Athens (GR), Singapore General Hospital (SG), Santa Casa Hospital (BR), Haukeland University Hospital (NO), Beaumont Hospital (IE), Hvidovre Hospital (DK), Tartu University Hospital (EE), Vancouver General Hospital (CA), Medical University of Sofia (BG), Kuwait University (KW), AVEO Oncology (United States) (US), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), Ruhrlandklinik (DE), St. Mary's Hospital (US), Kindai University Hospital (JP), Hospital Médica Sur (MX), Hospital Ramos Mejía (AR), University Hospital St. Ivan Rilski (BG), Education & Research Foundation (US), St. Mary's Hospital (US), Progenics Pharmaceuticals (United States) (US), Observational & Pragmatic Research Institute (SG), Fundación Neumológica Colombiana (CO), Medical University of Lodz (PL), Tampere University Hospital (FI), Office of Patient Care Services (US), Tampere University (FI), Decision Sciences (United States) (US), Centre for Health Technology and Services Research (PT), Skåne University Hospital (SE), University General Hospital Attikon (GR), Hospital Universitario Son Espases (ES), Hospital Universitario San Ignacio (CO), Colombian Association of Surgery (CO), The Catholic University of Korea Seoul St. Mary's Hospital (KR), IRCCS Humanitas Research Hospital (IT), Országos Korányi Tbc és Pulmonológiai Intézet (HU), Sydney Orthopaedic Research Institute (AU), Athens State University (US), University of Edinburgh (GB)
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Asthma and respiratory diseases
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