Evidence of efficacy of biologics in smokers with severe asthma in the SHARP CRC registry

<bold>Background:</bold> Real-world responses to biologics were assessed by cigarette smoking exposure. <bold>Methods:</bold> Clinical and functional data from 3,689 severe asthmatics in the ERS SHARP (Severe Heterogeneous Asthma Research-Patient Centred) registry were analyzed using the OMOP Common Data Model at baseline and after 1-year of treatment with biologics. <bold>Results:</bold> Among 2,282 never smokers, 505 ex-smokers (<10 pack-years [py]), 766 (≥10 py), and 136 current smokers, respectively, symptom control (ACT≥20/ACQ≤1.5) improved (+220%, +215%, +200%), frequent exacerbations (>2/year) decreased (-67%, -65%, -61%), AQLQ improved (+18%, +23%, +118%), and FEV1 pre-BD (%pred) increased (+10%, +9%, +6%) with no significant differences vs. never smokers, except for AQLQ for which current smokers experienced greatest improvement (Table 1). Survey of physicians showed that 25% oppose prescription of biologics to current smokers and >50% were dissatisfied with current treatment guidelines. <bold>Conclusion:</bold> Former/current smokers respond as well as never smokers to biologics, with AQLQ improving most in current smokers. Management disparities identified across Europe need for inclusive, evidence-based guidelines. <bold>Funding</bold> Unrestricted core funding by pharmaceutical SHARP CRC stakeholders. <table-wrap><object-id>erj;66/suppl_69/OA2210/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table1: Four-domain response (%change) by smoking groups 1 yr after starting biologics </caption><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Percent Change</td><td> never smokers N=2282 </td><td> ex-smokers <10PY N=505 </td><td> ex-smokers ≥10PY N=766 </td><td> current smokers N=136 </td></tr><tr><td>Controlled<sup>a</sup></td><td>+218.8</td><td>+220.0</td><td>+215.4</td><td>+200.0</td></tr><tr><td>≥2 exacerbations</td><td>-68.6</td><td>-66.7</td><td>-64.7</td><td>-61.3</td></tr><tr><td>AQLQ</td><td>+19.5</td><td>+18.4</td><td>+23.2</td><td><bold>+117.8</bold></td></tr><tr><td>FEV1%pred</td><td>+10.6</td><td>10.1</td><td>+9.0</td><td>6.3</td></tr></tbody></table></table-wrap> <sup>a</sup>Control is defined by ACT≥20 and/or ACQ≤1.5 and shown as percentage of % change vs. never smokers

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Published
2025-09-27
DOI
https://doi.org/10.1183/13993003.congress-2025.oa2210
Primary Topic
Asthma and respiratory diseases
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article
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article

Evidence of efficacy of biologics in smokers with severe asthma in the SHARP CRC registry

Florin Mihălţan, Piotr Kuna, Anneke Ten Brinke, Bilun Gemicioğlu et al.
Asthma and respiratory diseases
article

Evidence of efficacy of biologics in smokers with severe asthma in the SHARP CRC registry

Florin Mihălţan, Piotr Kuna, Anneke Ten Brinke, Bilun Gemicioğlu, Sabina Škrgat, Cristina Cardini, Jacob K. Sont, Dóra Lúðvíksdóttir, Aruna T. Bansal, Florence Schleich, Marco Caminati, Giorgio Walter Canonica, Zsuzsanna Csoma, ARNAUD AB BOURDIN, Kristina Biekšienė, Marina Lampalo, Ratko Djukanović, Sanja Popović‐Grle, Shane Hanon, Fabienne Jaun, Valentyna Yasinska, Jérémy Charriot, Marta Morawska, Enrico Marco Heffler, Sanja Hromiš, Celeste Porsbjerg, Peter Kopač, Ineta Grisle
article en

Abstract

<bold>Background:</bold> Real-world responses to biologics were assessed by cigarette smoking exposure. <bold>Methods:</bold> Clinical and functional data from 3,689 severe asthmatics in the ERS SHARP (Severe Heterogeneous Asthma Research-Patient Centred) registry were analyzed using the OMOP Common Data Model at baseline and after 1-year of treatment with biologics. <bold>Results:</bold> Among 2,282 never smokers, 505 ex-smokers (<10 pack-years [py]), 766 (≥10 py), and 136 current smokers, respectively, symptom control (ACT≥20/ACQ≤1.5) improved (+220%, +215%, +200%), frequent exacerbations (>2/year) decreased (-67%, -65%, -61%), AQLQ improved (+18%, +23%, +118%), and FEV1 pre-BD (%pred) increased (+10%, +9%, +6%) with no significant differences vs. never smokers, except for AQLQ for which current smokers experienced greatest improvement (Table 1). Survey of physicians showed that 25% oppose prescription of biologics to current smokers and >50% were dissatisfied with current treatment guidelines. <bold>Conclusion:</bold> Former/current smokers respond as well as never smokers to biologics, with AQLQ improving most in current smokers. Management disparities identified across Europe need for inclusive, evidence-based guidelines. <bold>Funding</bold> Unrestricted core funding by pharmaceutical SHARP CRC stakeholders. <table-wrap><object-id>erj;66/suppl_69/OA2210/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table1: Four-domain response (%change) by smoking groups 1 yr after starting biologics </caption><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Percent Change</td><td> never smokers N=2282 </td><td> ex-smokers <10PY N=505 </td><td> ex-smokers ≥10PY N=766 </td><td> current smokers N=136 </td></tr><tr><td>Controlled<sup>a</sup></td><td>+218.8</td><td>+220.0</td><td>+215.4</td><td>+200.0</td></tr><tr><td>≥2 exacerbations</td><td>-68.6</td><td>-66.7</td><td>-64.7</td><td>-61.3</td></tr><tr><td>AQLQ</td><td>+19.5</td><td>+18.4</td><td>+23.2</td><td><bold>+117.8</bold></td></tr><tr><td>FEV1%pred</td><td>+10.6</td><td>10.1</td><td>+9.0</td><td>6.3</td></tr></tbody></table></table-wrap> <sup>a</sup>Control is defined by ACT≥20 and/or ACQ≤1.5 and shown as percentage of % change vs. never smokers

Reykjavík University (IS), Lithuanian University of Health Sciences (LT), Karolinska University Hospital (SE), Humanitas University (IT), Vrije Universiteit Brussel (BE), University Hospital Centre Zagreb (HR), Inserm (FR), University of Liège (BE), Université de Montpellier (FR), Southampton Hospital (US), Leiden University Medical Center (NL), Ljubljana University Medical Centre (SI), Southampton General Hospital (GB), TeraView (United Kingdom) (GB), Bispebjerg Hospital (DK), Medisch Centrum Leeuwarden (NL), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), Kantonsspital Baselland (CH), Riga East University Hospital (LV), Psychiatry Baselland (CH), National University Hospital of Iceland (IS), Istanbul University-Cerrahpaşa (TR), University Clinic of Pulmonary and Allergic Diseases Golnik (SI), Clinica de Pneumologie Iaşi (RO), Medical University of Lodz (PL), Theological Seminary Bienenberg (CH), Swedish Asthma and Allergy Association (SE), Institute for Pulmonary Diseases of Vojvodina (RS), STMicroelectronics (Italy) (IT), IRCCS Humanitas Research Hospital (IT), Országos Korányi Tbc és Pulmonológiai Intézet (HU)
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Asthma and respiratory diseases
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