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00925njm 22002777a 4500 dc Chen, Wenjia author Tran, Trung N author Sadatsafavi, Mohsen author Murray, Ruth author Wong, Nigel Chong Boon author Ali, Nasloon author Ariti, Con author Bulathsinhala, Lakmini author Gil, Esther Garcia author FitzGerald, J Mark 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 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 Fonseca, João A author Gibson, Peter G 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 author Lyu, Juntao author Mahboub, Bassam author Maspero, Jorge author Menzies-Gow, Andrew N author Newell, Anthony author Sirena, Concetta author Papadopoulos, Nikolaos G author Papaioannou, Andriana I author Perez-de-Llano, Luis author Perng Steve, 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 author 2023-09 Background: Effectiveness of biologics has neither been established in patients with high oral corticosteroid exposure (HOCS) nor been compared with effectiveness of continuing with HOCS alone. Objective: To examine the effectiveness of initiating biologics in a large, real-world cohort of adult patients with severe asthma and HOCS. Methods: This was a propensity score-matched, prospective cohort study using data from the International Severe Asthma Registry. Between January 2015 and February 2021, patients with severe asthma and HOCS (long-term OCSs for ≥1 year or ≥4 courses of rescue OCSs within a 12-month period) were identified. Biologic initiators were identified and, using propensity scores, matched 1:1 with noninitiators. The impact of biologic initiation on asthma outcomes was assessed using generalized linear models. Results: We identified 996 matched pairs of patients. Both groups improved over the 12-month follow-up period, but improvement was greater for biologic initiators. Biologic initiation was associated with a 72.9% reduction in the average number of exacerbations per year versus noninitiators (0.64 vs 2.06; rate ratio, 0.27 [95% CI, 0.10-0.71]). Biologic initiators were 2.2 times more likely than noninitiators to take a daily long-term OCS dose of less than 5 mg (risk probability, 49.6% vs 22.5%; P = .002) and had a lower risk of asthma-related emergency department visits (relative risk, 0.35 [95% CI, 0.21-0.58]; rate ratio, 0.26 [0.14-0.48]) and hospitalizations (relative risk, 0.31 [95% CI, 0.18-0.52]; rate ratio, 0.25 [0.13-0.48]). Conclusions: In a real-world setting, including patients with severe asthma and HOCS from 19 countries, and within an environment of clinical improvement, initiation of biologics was associated with further improvements across multiple asthma outcomes, including exacerbation rate, OCS exposure, and health care resource utilization. Chen W, Tran TN, Sadatsafavi M, Murray R, Wong NCB, Ali N, et al. Impact of initiatinG bioLogics In patients with severe asThma on long-Term OCS or frEquent Rescue steroids (GLITTER): data from the International Severe Asthma Registry. J allergy Clin Immunol Pract. 2023 Jun 8. 10.1016/j.jaip.2023.05.044 2213-2201 The journal of allergy and clinical immunology. In practice https://hdl.handle.net/20.500.13003/19961 37301430 L2025685705 2-s2.0-85164597997 https://hdl.handle.net/20.500.12105/23683 792480406159 Impact of Initiating Biologics in Patients With Severe Asthma on Long-Term Oral Corticosteroids or Frequent Rescue Steroids (GLITTER): Data From the International Severe Asthma Registry.