Περίληψη:
Introduction: International registries provide opportunities to describe
use of biologics for treating severe asthma in current clinical
practice. Our aims were to describe real-life global patterns of
biologic use (continuation, switches, and discontinuations) for severe
asthma, elucidate reasons underlying these patterns, and examine
associated patient-level factors.
Methods: This was a historical cohort study including adults with severe
asthma enrolled into the International Severe Asthma Registry (ISAR;
http://isaregistries.org, 2015-2020) or the CHRONICLE Study (2018-2020)
and treated with a biologic. Eleven countries were included (Bulgaria,
Canada, Denmark, Greece, Italy, Japan, Kuwait, South Korea, Spain, UK,
and USA). Biologic utilization patterns were defined: 1) continuing
initial biologic; 2) stopping biologic treatment; or 3) switching to
another biologic. Reasons for discontinuation/switching were recorded
and comparisons drawn between groups.
Results: A total of 3531 patients were included. Omalizumab was the most
common initial biologic in 2015 (88.2%) and benralizumab in 2019
(29.6%). Most patients (79%; 2791/3531) continued their first
biologic; 10.2% (356/3531) stopped; 10.8% (384/3531) switched. The
most frequent first switch was from omalizumab to an anti-IL-5/5R
(49.6%; 187/377). The most common subsequent switch was from one
anti-IL-5/5R to another (44.4%; 20/45). Insufficient efficacy and/or
adverse effects were the most frequent reasons for stopping/switching.
Patients who stopped/switched were more likely to have a higher baseline
blood eosinophil count and exacerbation rate, lower lung function, and
greater health care resource utilization.
Conclusion: The description of real-life patterns of continuing,
stopping, or switching biologics enhances our understanding of global
biologic use. Prospective studies involving structured switching
criteria could ascertain optimal strategies to identify patients who may
benefit from switching.
Συγγραφείς:
Menzies-Gow, Andrew N.
McBrien, Claire
Unni, Bindhu and
Porsbjerg, Celeste M.
Al-Ahmad, Mona
Ambrose, Christopher S. and
Assing, Karin Dahl
von Bulow, Anna
Busby, John
Cosio, Borja
G.
FitzGerald, J. Mark
Gil, Esther Garcia
Hansen, Susanne
and aHeaney, Liam G.
Hew, Mark
Jackson, David J.
Kallieri,
Maria
Loukides, Stelios
Lugogo, Njira L.
Papaioannou, I,
Andriana
Larenas-Linnemann, Desiree
Moore, Wendy C. and
Perez-de-Llano, Luis A.
Rasmussen, Linda M.
Schmid, Johannes M.
and Siddiqui, Salman
Alacqua, Marianna
Tran, Trung N.
Ulrik,
Charlotte Suppli
Upham, John W.
Wang, Elleen
Bulathsinhala,
Lakmini
Carter, Victoria A.
Chaudhry, Isha
Eleangovan, Neva
and Murray, Ruth B.
Price, Chris A.
Price, David B.