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.
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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, Wang Hao-Chien, 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, ISAR SOLAR I Working Group
Аннотация
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.