TY - JOUR
T1 - Impact of Initiating Biologics in Patients With Severe Asthma on Long-Term Oral Corticosteroids or Frequent Rescue Steroids (GLITTER)
T2 - Data From the International Severe Asthma Registry
AU - Chen, Wenjia
AU - Tran, Trung N.
AU - Sadatsafavi, Mohsen
AU - Murray, Ruth
AU - Wong, Nigel Chong Boon
AU - Ali, Nasloon
AU - Ariti, Con
AU - Bulathsinhala, Lakmini
AU - Gil, Esther Garcia
AU - FitzGerald, J. Mark
AU - Alacqua, Marianna
AU - Al-Ahmad, Mona
AU - Altraja, Alan
AU - Al-Lehebi, Riyad
AU - Bhutani, Mohit
AU - Bjermer, Leif
AU - Bjerrum, Anne Sofie
AU - Bourdin, Arnaud
AU - von Bülow, Anna
AU - Busby, John
AU - Canonica, Giorgio Walter
AU - Carter, Victoria
AU - Christoff, George C.
AU - Cosio, Borja G.
AU - Costello, Richard W.
AU - Fonseca, João A.
AU - Gibson, Peter G.
AU - Yoo, Kwang Ha
AU - Heaney, Liam G.
AU - Heffler, Enrico
AU - Hew, Mark
AU - Hilberg, Ole
AU - Hoyte, Flavia
AU - Iwanaga, Takashi
AU - Jackson, David J.
AU - Jones, Rupert C.
AU - Koh, Mariko Siyue
AU - Kuna, Piotr
AU - Larenas-Linnemann, Désirée
AU - Lehmann, Sverre
AU - Lehtimäki, Lauri
AU - Lyu, Juntao
AU - Mahboub, Bassam
AU - Maspero, Jorge
AU - Menzies-Gow, Andrew N.
AU - Newell, Anthony
AU - Sirena, Concetta
AU - Papadopoulos, Nikolaos G.
AU - Papaioannou, Andriana I.
AU - Perez-de-Llano, Luis
AU - Perng (Steve), Diahn Warng
AU - Peters, Matthew
AU - Pfeffer, Paul E.
AU - Porsbjerg, Celeste M.
AU - Popov, Todor A.
AU - Rhee, Chin Kook
AU - Salvi, Sundeep
AU - Taillé, Camille
AU - Taube, Christian
AU - Torres-Duque, Carlos A.
AU - Ulrik, Charlotte
AU - Ra, Seung Won
AU - Wang, Eileen
AU - Wechsler, Michael E.
AU - Price, David B.
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Biologics
KW - Effectiveness
KW - ISAR
KW - Oral corticosteroids
KW - Real life
UR - https://www.scopus.com/pages/publications/85164597997
U2 - 10.1016/j.jaip.2023.05.044
DO - 10.1016/j.jaip.2023.05.044
M3 - Article
C2 - 37301430
AN - SCOPUS:85164597997
SN - 2213-2198
VL - 11
SP - 2732
EP - 2747
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 9
ER -