P098 Asthma control in patients receiving systemic therapy for atopic eczema: results from the UK Atopic eczema Systemic TherApy Register (A-STAR)

Abstract Asthma is one of the common comorbidities associated with atopic eczema (AE). Systemic medications used for treating AE have immunomodulatory effects, which might also impact asthma control. We evaluated asthma control in A-STAR patients initiating systemic immunomodulatory therapy who also had a physician’s diagnosis of asthma. A-STAR is a prospective longitudinal register evaluating the effectiveness and safety of systemic medications in patients with AE. For this analysis, inclusion criteria consisted of patients ≥ 12 years old with physician-diagnosed asthma who completed the validated Asthma Control Test (ACT) questionnaire. The ACT was completed at baseline and week 16 (± 4 weeks), enquiring about asthma control in the past 4 weeks. An ACT score of 20–25 is considered an indicator of well-controlled asthma. Adjusted logistic regression was used to identify predictors of achieving good asthma control at week 16. Adjusted odds ratios and corresponding 95% confidence intervals were estimated. In total, 303 A-STAR register patients with concurrent asthma were included in the analysis, with a mean age of 33.6 years (SD 3.6); 58.2% were female and 41.8% were male. Treatments initiated at enrolment included dupilumab (n = 148), methotrexate (n = 66), Janus kinase inhibitors (abrocitinib or upadacitinib, n = 52) and ciclosporin (n = 37). At baseline, the mean Eczema Area and Severity Index and ACT scores were 19.5 (SD 2.4) and 20.3 (SD 0.6), respectively. More than 50% of patients had well-controlled asthma at baseline in each drug group. At week 16, there was no significant change in asthma control, with a mean (SD) ACT of 20.0 (0.8). In multivariable regression analysis, prescription of dupilumab and higher baseline ACT scores were associated with good asthma control at week 16 (ACT 20–25; Table). Overall, there was no significant change in asthma control between baseline and week 16 with any of the examined systemic treatments. However, patients with dupilumab and higher ACT score were more likely to achieve good asthma control at 16 weeks. We plan further, similar analyses on individual drug groups in relation to asthma control, as the number of A-STAR patients in individual drug groups increases over time, enhancing statistical power.TablePredictors of achieving good asthma control (Asthma Control Test 20–25) at week 16 in multivariable analysisVariableAdjusted odds ratio (95% confidence interval)aDrug groupJanus kinase inhibitors1 (reference)Ciclosporin3.32 (0.69–17.0)Dupilumab3.34 (1.28–9.03)*Methotrexate2.89 (0.78–11.4)Baseline asthma control test score1.31 (1.20–1.45)**P < 0.05. aAdjusted for baseline Eczema Area and Severity Index and Patient-Oriented Eczema Measure, number of prior oral systemic treatments, sex, age of atopic eczema onset, age of drug initiation and Fitzpatrick skin type.