Impact of Biologics Initiation on Oral Corticosteroid Use in the International Severe Asthma Registry and the Optimum Patient Care Research Database: A Pooled Analysis of Real-World Data.
Journal
The journal of allergy and clinical immunology. In practice
ISSN
2213-2201
Date Issued
2025-04-26
Author(s)
Chen, Wenjia
Tran, Trung N
Townend, John
Christoff, George C
Tsai, Ming-Ju
Altraja, Alan
Cochrane, Belinda
Cosio, Borja G
Sivori, Martin
Murray, Ruth B
Makris, Michael P
Scelo, Ghislaine
Bulathsinhala, Lakmini
Ardusso, Ledit R F
Franchi, María Eugenia
Máspero, Jorge
Saldarini, Fernando
Stok, Ana María
Tomaszuk, Ana Giselle
Yañez, Anahí
Emmanuel, Benjamin
Emmas, Cathy
Kostikas, Konstantinos
Menzies-Gow, Andrew N
Stjepanovic, Neda
Bosnic-Anticevich, Sinthia Z
Denton, Eve
Gibson, Peter G
Hew, Mark
Jenkins, Christine
Middleton, Peter G
Peters, Matthew J
Upham, John W
Brusselle, Guy G
Louis, Renaud
Schleich, Florence
Pitrez, Paulo Márcio
Popov, Todor A
Bergeron, Celine
Bhutani, Mohit
Chapman, Kenneth R
Côté, Andréanne
Couillard, Simon
Dorscheid, Delbert R
Lougheed, M Diane
Sadatsafavi, Mohsen
Celis-Preciado, Carlos Andrés
Jiménez-Maldonado, Libardo
Rodríguez-Cáceres, Bellanid
Cano Rosales, Diana Jimena
Solarte, Ivan
Torres-Duque, Carlos A
Hansen, Susanne
Porsbjerg, Celeste M
Ulrik, Charlotte Suppli
Bourdin, Arnaud
Bakakos, Petros
Exarchos, Konstantinos P
Gogali, Athena
Ladias, Aggelos A
Papadopoulos, Nikolaos G
Papaioannou, Andriana I
Costello, Richard W
Cushen, Breda
Mitchell, Patrick D
Canonica, Giorgio Walter
Heffler, Enrico
Puggioni, Francesca
Iwanaga, Takashi
Nagano, Tatsuya
Tohda, Yuji
Al-Ahmad, Mona S
Larenas-Linnemann, Désirée
Aarli, Bernt Bøgvald
Lehmann, Sverre
Kuna, Piotr
Ferreira, José Alberto
Fonseca, João A
Loureiro, Cláudia Chaves
Al-Lehebi, Riyad
Bulkhi, Adeeb A
Juang, Yah Ru
Koh, Mariko Siyue
Liu, Anqi
Rhee, Chin Kook
Perez-de-Llano, Luis
Fu, Pin-Kuei
Perng, Diahn-Warng
Sheu, Chau-Chyun
Mahboub, Bassam
Salameh, Laila
Busby, John
Heaney, Liam G
Jackson, David J
Patel, Pujan H
Pfeffer, Paul E
Hoyte, Flavia
Katial, Rohit K
Lugogo, Njira
Pleasants, Roy Alton
Wang, Eileen
Wechsler, Michael E
Beastall, Aaron
Carter, Victoria
Eleangovan, Nevaashni
Fletton, Kirsty
Price, David B
Abstract
Background: For severe asthma (SA) management, real-world evidence on the effects of biologic therapies in reducing the burden of oral corticosteroid (OCS) use is limited. Objective: To estimate the efficacy of biologic initiation on total OCS (TOCS) exposure in patients with SA from real-world specialist and primary care settings. Methods: From the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, United Kingdom), adult biologic initiators were identified and propensity score-matched with non-initiators (ISAR, 1:1; OPCRD, 1:2). The impact of biologic initiation on TOCS (including bursts for exacerbations) daily dose in the first- and second-year follow-up period was estimated using multivariable generalized linear models. Results: Among 5,663 patients (ISAR 48%, OPCRD 52%), the odds ratios (ORs) of biologic initiators achieving TOCS cessation in the first and second years of follow-up were 2.38 (95% CI, 1.87-3.04) and 2.11 (95% CI, 1.65-2.70), whereas the ORs of low (0- to 5-mg) TOCS intake were 1.62 (95% CI, 1.40-1.86) and 1.40 (95% CI, 1.21-1.61), respectively. Compared with non-initiators, biologic initiators had a substantially higher chance of achieving greater than 75% reduction from baseline (OR [95% CI] = 2.35 [2.06-2.68] and 1.53 [1.35-1.73] in first and second years, respectively). These findings remained persistent and robust when analyses were repeated with one country setting removed at a time. Conclusions: Biologic initiation in patients with SA led to substantial reduction in TOCS exposure, particularly in the first year. Future analyses will explore the impact on OCS-related adverse health events.
Subjects
Anti-IL-4/13
Anti-IL-5
Anti-IgE
Biologics
Corticosteroids
Difficult-to-treat asthma
Monoclonal antibody
Oral corticosteroids
Real-world evidence
Severe asthma
Type
journal article