Sub-Optimal Disease Control and Low Blood Eosinophil Testing Frequency in Chinese Adult Patients with Asthma Receiving GINA Step 4/5 Treatment: A Real-World Study

Victoria S Benson,1,* James Siddall,2,* Adam Haq,2 Mark Small,2 Zhiliu Tang,3 Tao Ye,4 Peter Howarth,5 Anna Richards,6 Rafael Alfonso-Cristancho7 1Epidemiology, Value Evidence & Outcomes, GSK, London, UK; 2Adelphi Real World, Bollington, UK; 3Value Evidence & Outcomes, GSK, Shanghai, People’s Republic of China; 4Medical Affairs, Respiratory, GSK, Shanghai, People’s Republic of China; 5Global Respiratory Franchise, GSK, Brentford, UK; 6Value Evidence & Outcomes, GSK, London, UK; 7Value Evidence & Outcomes, GSK, Philadelphia, Pennsylvania, USA*These authors contributed equally to this workCorrespondence: Tao Ye, Medical Affairs, Respiratory, GSK, 902 halei Road, Pudong, Shanghai, People’s Republic of China, Email [email protected]: To inform effective management strategies for severe asthma in China, this study aimed to comprehensively characterize clinical characteristics, treatment patterns, disease control status, and healthcare resource utilization among patients on GINA Step 4/5 therapies by analyzing data from the Adelphi Asthma Disease Specific Program conducted in China.Patients and methods: All information was retrieved from medical records or collected from physicians and patients on the survey date (August–December 2018); no follow-up was conducted. Results were summarized descriptively for patients on GINA Step 4/5 therapies, who were pooled from a consecutive sample (comprising three or more consecutive patients with physician-diagnosed asthma from each participating physician) and an oversample (comprising the next two patients with physician-perceived severe asthma from each participating physician).Results: Of the included patients (n=754), 51.5% had ever had a blood eosinophil measurement taken, 22.1% had available records for their most recent blood eosinophil measurements (68.9% of them had an elevated level ≥ 150 cells/μL), 39.9% had ever been tested for specific immunoglobulin E or radioallergosorbent, and 8.0% were prescribed maintenance oral corticosteroids. Asthma was not well controlled in 69.2% of patients. In the prior year, 27.1% experienced at least one severe exacerbation and 22.8% experienced at least one hospitalization (emergency visit or overnight stay) due to asthma.Conclusion: In Chinese patients with asthma on GINA Step 4/5 therapies, biomarker testing was underutilized, asthma was not well controlled, and severe exacerbations were not infrequent. These findings highlight the urgent need for optimized asthma management for patients on GINA Step 4/5 therapies in China.Keywords: severe asthma, type-2 high asthma, real-world, phenotype, exacerbations, health care resource utilization, eosinophils