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oai:repisalud.isciii.es:20.500.12105/233992024-10-04T13:16:30Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud author Chen, Wenjia author Sadatsafavi, Mohsen author Tran, Trung N author Murray, Ruth B author Wong, Chong Boon Nigel author Ali, Nasloon author Ariti, Cono author Garcia Gil, Esther author Newell, Anthony author Alacqua, Marianna author Al-Ahmad, Mona author Altraja, Alan author Al-Lehebi, Riyad author Bhutani, Mohit author Bjermer, Leif author Bjerrum, Anne Sofie author Bourdin, Arnaud author Bulathsinhala, Lakmini author von Bülow, Anna author Busby, John author Canonica, Giorgio Walter author Carter, Victoria author Christoff, George C author García-Cosío, Borja author Costello, Richard W author FitzGerald, J Mark author Fonseca, Joao A. author Yoo, Kwang Ha author Heaney, Liam G. author Heffler, Enrico author Hew, Mark author Hilberg, Ole author Hoyte, Flavia author Iwanaga, Takashi author Jackson, David J author Jones, Rupert C author Koh, Mariko Siyue author Kuna, Piotr author Larenas-Linnemann, Désirée author Lehmann, Sverre author Lehtimäki, Lauri A author Lyu, Juntao author Mahboub, Bassam author Maspero, Jorge author Menzies-Gow, Andrew N author Sirena, Concetta author Papadopoulos, Nikolaos G author Papaioannou, Andriana I author Perez de Llano, Luis Alejandro author Perng, Diahn-Warng author Peters, Matthew author Pfeffer, Paul E author Porsbjerg, Celeste M author Popov, Todor A author Rhee, Chin Kook author Salvi, Sundeep author Taillé, Camille author Taube, Christian author Torres-Duque, Carlos A author Ulrik, Charlotte Suppli author Ra, Seung Won author Wang, Eileen author Wechsler, Michael E author Price, David B 2024-10-04T13:16:30Z 2024-10-04T13:16:30Z 2022 Chen W, Sadatsafavi M, Tran TN, Murray RB, Wong CBN, Ali N, et al. Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy. J Asthma Allergy. 2022;15:1491-510. 10.2147/JAA.S377174 1178-6965 Journal of asthma and allergy https://hdl.handle.net/20.500.13003/18837 36303891 L2018329739 2-s2.0-85141030684 https://hdl.handle.net/20.500.12105/23399 898765700001 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. eng Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy research article