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Article Dans Une Revue Journal of Asthma and Allergy Année : 2022

Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy

Wenjia Chen (1) , Mohsen Sadatsafavi (2) , Trung N. Tran (3) , Ruth Murray , Chong Boon Nigel Wong (1) , Nasloon Ali (3) , Cono Ariti (3) , Esther Garcia Gil (3) , Anthony Newell , Marianna Alacqua (3) , Mona Al-Ahmad (4) , Alan Altraja (5) , Riyad Al-Lehebi (6, 7) , Mohit Bhutani (8) , Leif Bjermer (9) , Anne Sofie Bjerrum (10) , Arnaud Bourdin (11) , Lakmini Bulathsinhala , Anna von Bülow , John Busby (12) , Giorgio Walter Canonica (13) , Victoria Carter , George Christoff (14) , Borja Cosio (15) , Richard Costello (16) , J Mark Fitzgerald (17) , João Fonseca (18) , Kwang Ha Yoo (19) , Liam G. Heaney (12) , Enrico Heffler (13) , Mark Hew (20, 21) , Ole Hilberg , Flavia Hoyte (22, 23) , Takashi Iwanaga (24) , David J. Jackson (25, 26) , Rupert Jones (27) , Mariko Siyue Koh (28) , Piotr Kuna (29) , Désirée Larenas-Linnemann , Sverre Lehmann (30) , Lauri Lehtimäki (31) , Juntao Lyu , Bassam Mahboub (32, 33) , Jorge Maspero , Andrew N. Menzies-Gow (34) , Concetta Sirena , Nikolaos Papadopoulos (35, 36) , Andriana Papaioannou (37) , Luis Pérez de Llano (38) , Diahn-Warng Perng (39) , Matthew Peters (40) , Paul E. Pfeffer (41) , Celeste M. Porsbjerg (42) , Todor Popov (14) , Chin Kook Rhee (43) , Sundeep Salvi (44) , Camille Taillé (45) , Christian Taube (46) , Carlos Torres-Duque , Charlotte Ulrik (47) , Seung Won Ra (48) , Eileen Wang (22, 23) , Michael Wechsler (22) , David Price (49)
1 NUS - National University of Singapore
2 UBC - University of British Columbia
3 AstraZeneca
4 Kuwait University
5 University of Tartu
6 KFMC - King Fahad Medical City [Riyadh]
7 Alfaisal University
8 University of Alberta
9 Skane University Hospital [Lund]
10 Aarhus University Hospital
11 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
12 QUB - Queen's University [Belfast]
13 IRCCS Milan - Istituto Clinico Humanitas [Milan]
14 Medical University of Sofia [Bulgarie]
15 IdISBa - Fundació Institut d'Investigació Sanitària Illes Balears
16 HB - Hôpital de Beaumont [Dublin, Ireland]
17 University of British Columbia [Vancouver]
18 Universidade do Porto = University of Porto
19 Konkuk University [Seoul]
20 Alfred Health
21 Monash University [Melbourne]
22 NJH - National Jewish Health
23 University of Colorado Anschutz [Aurora]
24 Kindai University
25 Guy's and St Thomas' NHS Foundation Trust
26 King‘s College London
27 Plymouth University
28 NUH - National University Hospital [Singapore]
29 MUL - Medical University of Łódź
30 UiB - University of Bergen
31 Tampere University Hospital
32 UoS - University of Sharjah
33 MBRU - Mohammed Bin Rashid University of Medicine and Health Sciences
34 Royal Brompton and Harefield NHS Foundation Trust
35 University of Manchester [Manchester]
36 University of Athens Medical School [Athens]
37 NKUA - National and Kapodistrian University of Athens
38 IDIS - Instituto de Investigación Sanitaria de Santiago de Compostela / Health Research Institute of Santiago de Compostela
39 Taipei Medical University
40 The University of Sydney
41 Barts Health NHS Trust [London, UK]
42 UCPH - University of Copenhagen = Københavns Universitet
43 Catholic University of Korea
44 IISER Pune - Indian Institute of Science Education and Research Pune
45 CIC Hôpital Bichat
46 AöR - University Hospital Essen
47 Copenhagen University Hospital
48 University of Ulsan
49 University of Aberdeen
Wenjia Chen
  • Fonction : Auteur
National University of Singapore
Mohsen Sadatsafavi
University of British Columbia
Trung N. Tran
  • Fonction : Auteur
AstraZeneca
Ruth Murray
  • Fonction : Auteur
Chong Boon Nigel Wong
National University of Singapore
Nasloon Ali
AstraZeneca
Cono Ariti
  • Fonction : Auteur
AstraZeneca
Esther Garcia Gil
  • Fonction : Auteur
AstraZeneca
Anthony Newell
Marianna Alacqua
  • Fonction : Auteur
AstraZeneca
Mona Al-Ahmad
Kuwait University
Alan Altraja
  • Fonction : Auteur
University of Tartu
Riyad Al-Lehebi
King Fahad Medical City [Riyadh]
Alfaisal University
Mohit Bhutani
  • Fonction : Auteur
University of Alberta
Leif Bjermer
Skane University Hospital [Lund]
Anne Sofie Bjerrum
  • Fonction : Auteur
Aarhus University Hospital
Arnaud Bourdin
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
Lakmini Bulathsinhala
  • Fonction : Auteur
Anna von Bülow
  • Fonction : Auteur
John Busby
  • Fonction : Auteur
Queen's University [Belfast]
Giorgio Walter Canonica
Istituto Clinico Humanitas [Milan]
Victoria Carter
  • Fonction : Auteur
George Christoff
Medical University of Sofia [Bulgarie]
Borja Cosio
Fundació Institut d'Investigació Sanitària Illes Balears
Richard Costello
Hôpital de Beaumont [Dublin, Ireland]
J Mark Fitzgerald
  • Fonction : Auteur
University of British Columbia [Vancouver]
João Fonseca
  • Fonction : Auteur
Universidade do Porto = University of Porto
Kwang Ha Yoo
Konkuk University [Seoul]
Liam G. Heaney
  • Fonction : Auteur
Queen's University [Belfast]
Enrico Heffler
  • Fonction : Auteur
Istituto Clinico Humanitas [Milan]
Mark Hew
  • Fonction : Auteur
Alfred Health
Monash University [Melbourne]
Ole Hilberg
Flavia Hoyte
  • Fonction : Auteur
National Jewish Health
University of Colorado Anschutz [Aurora]
Takashi Iwanaga
Kindai University
David J. Jackson
  • Fonction : Auteur
Guy's and St Thomas' NHS Foundation Trust
King‘s College London
Rupert Jones
Plymouth University
Mariko Siyue Koh
  • Fonction : Auteur
National University Hospital [Singapore]
Piotr Kuna
  • Fonction : Auteur
Medical University of Łódź
Désirée Larenas-Linnemann
Sverre Lehmann
  • Fonction : Auteur
University of Bergen
Lauri Lehtimäki
Tampere University Hospital
Juntao Lyu
Bassam Mahboub
  • Fonction : Auteur
University of Sharjah
Mohammed Bin Rashid University of Medicine and Health Sciences
Jorge Maspero
  • Fonction : Auteur
Andrew N. Menzies-Gow
  • Fonction : Auteur
Royal Brompton and Harefield NHS Foundation Trust
Concetta Sirena
  • Fonction : Auteur
Nikolaos Papadopoulos
University of Manchester [Manchester]
University of Athens Medical School [Athens]
Andriana Papaioannou
National and Kapodistrian University of Athens
Luis Pérez de Llano
Instituto de Investigación Sanitaria de Santiago de Compostela / Health Research Institute of Santiago de Compostela
Diahn-Warng Perng
  • Fonction : Auteur
Taipei Medical University
Matthew Peters
  • Fonction : Auteur
The University of Sydney
Paul E. Pfeffer
  • Fonction : Auteur
Barts Health NHS Trust [London, UK]
Celeste M. Porsbjerg
  • Fonction : Auteur
University of Copenhagen = Københavns Universitet
Todor Popov
Medical University of Sofia [Bulgarie]
Chin Kook Rhee
  • Fonction : Auteur
Catholic University of Korea
Sundeep Salvi
  • Fonction : Auteur
Indian Institute of Science Education and Research Pune
Camille Taillé
  • Fonction : Auteur
CIC Hôpital Bichat
Christian Taube
  • Fonction : Auteur
University Hospital Essen
Carlos Torres-Duque
Charlotte Ulrik
Copenhagen University Hospital
Seung Won Ra
University of Ulsan
Eileen Wang
  • Fonction : Auteur
National Jewish Health
University of Colorado Anschutz [Aurora]
Michael Wechsler
National Jewish Health
David Price
University of Aberdeen

Résumé

Background: Many severe asthma patients with high oral corticosteroid exposure (HOCS) often do not initiate biologics despite being eligible. This study aimed to compare the characteristics of severe asthma patients with HOCS who did and did not initiate biologics. Methods: Baseline characteristics of patients with HOCS (long-term maintenance OCS therapy for at least 1 year, or ≥4 courses of steroid bursts in a year) from the International Severe Asthma Registry (ISAR; https://isaregistries.org/), who initiated or did not initiate biologics (anti-lgE, anti-IL5/5R or anti-IL4R), were described at the time of biologic initiation or registry enrolment. Statistical relationships were tested using Pearson's chi-squared tests for categorical variables, and t-tests for continuous variables, adjusting for potential errors in multiple comparisons. Results: Between January 2015 and February 2021, we identified 1412 adult patients with severe asthma from 19 countries that met our inclusion criteria of HOCS, of whom 996 (70.5%) initiated a biologic and 416 (29.5%) did not. The frequency of biologic initiation varied across geographical regions. Those who initiated a biologic were more likely to have higher blood eosinophil count (483 vs 399 cells/µL, p=0.003), serious infections (49.0% vs 13.3%, p<0.001), nasal polyps (35.2% vs 23.6%, p<0.001), airflow limitation (56.8% vs 51.8%, p=0.013), and uncontrolled asthma (80.8% vs 73.2%, p=0.004) despite greater conventional treatment adherence than those who did not start a biologic. Both groups had similar annual asthma exacerbation rates in the previous 12 months (5.7 vs 5.3, p=0.147). Conclusion: Around one third of severe HOCS asthma patients did not receive biologics despite a similar high burden of asthma exacerbations as those who initiated a biologic therapy. Other disease characteristics such as eosinophilic phenotype, serious infectious events, nasal polyps, airflow limitation and lack of asthma control appear to dictate biologic use.

Domaines

Pneumologie et système respiratoire Allergologie

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https://hal.umontpellier.fr/hal-04391095

Soumis le : vendredi 12 janvier 2024-15:21:15

Dernière modification le : vendredi 2 février 2024-03:32:29

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Dates et versions

hal-04391095 , version 1 (12-01-2024)

Identifiants

Citer

Wenjia Chen, Mohsen Sadatsafavi, Trung N. Tran, Ruth Murray, Chong Boon Nigel Wong, et al.. Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy. Journal of Asthma and Allergy, 2022, Volume 15, pp.1491-1510. ⟨10.2147/JAA.S377174⟩. ⟨hal-04391095⟩

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