Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study.
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Guilleminault Laurent, Camus Claire, Raherison-Semjen Chantal, Capdepon Audrey, Bourdin Arnaud, Bonniaud Philippe, Fry Stéphanie, Devouassoux Gilles, Blanc François-Xavier, Pison Christophe, Dupin Clairelyne, Khayath Naji, Courdeau Joelle, Valcke-Brossollet Judith, Nocent-Ejnaini Cécilia, Rolland Fabien, Lamandi Carmen, Proust Alain, Ozier Anaig, Portel Laurent, Gaspard Wanda, Roux-Claude Pauline, Beurnier Antoine, Martinez Stéphanie, Dot Jean-Marc, Hennegrave Florence, Vignal Guillaume, Auvray Etienne, Paleiron Nicolas, Just Nicolas, Miltgen Jean, Russier Maud, Olivier Cécile, Taillé Camille, Didier Alain
Аннотация
PURPOSE: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics.
DESIGN: The Second Souffle study is a real-life prospective observational study endorsed by the Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science Network.
METHODS: Adults with a confirmed diagnosis of severe asthma for at least 12 months' duration were enrolled in the study. A self-administered questionnaire including the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) and a compliance evaluation test was given to the patients. Healthcare consumption within 12 months prior to enrolment was documented. In patients receiving biologics, doctors indicated whether the patients were biologic responders or non-responders.
RESULTS: The characteristics of 431 patients with severe asthma were analysed. Among them, 409 patients (94.9%) presented asthma with type 2 inflammation (T2 high) profile, and 297 (72.6%) patients with a T2 high phenotype were treated with a biologic. Physicians estimated that 88.2% of patients receiving biologics were responders. However, asthma control was only achieved in 25.3% of those patients (ACQ > 0.75). A high proportion of patients (77.8%) identified as responders to biologics were not controlled according to the ACQ score. About 50% of patients continue to use oral corticosteroids either daily (25.2%) or more than three times a year for at least three consecutive days (25.6%). Gastro-oesophageal Reflux Disease (GERD) and Obstructive Sleep Apnoea syndrome (OSA) were identified as independent factors associated with uncontrolled asthma.
CONCLUSION: Although a high proportion of severe asthma patients respond to biologics, only 25.3% have controlled asthma. GERD and OSA are independent factors of uncontrolled asthma.