TY - JOUR
T1 - Real World Biologic Use and Switch Patterns in Severe Asthma
T2 - Data from the International Severe Asthma Registry and the US CHRONICLE Study
AU - Menzies-Gow, Andrew N.
AU - McBrien, Claire
AU - Unni, Bindhu
AU - Porsbjerg, Celeste M.
AU - Al-Ahmad, Mona
AU - Ambrose, Christopher S.
AU - Dahl Assing, Karin
AU - von Bülow, Anna
AU - Busby, John
AU - Cosio, Borja G.
AU - Fitzgerald, J. Mark
AU - Garcia Gil, Esther
AU - Hansen, Susanne
AU - Aheaney, Liam G.
AU - Hew, Mark
AU - Jackson, David J.
AU - Kallieri, Maria
AU - Loukides, Stelios
AU - Lugogo, Njira L.
AU - Papaioannou, Andriana I.
AU - Larenas-Linnemann, Désirée
AU - Moore, Wendy C.
AU - Perez-De-llano, Luis A.
AU - Rasmussen, Linda M.
AU - Schmid, Johannes M.
AU - Siddiqui, Salman
AU - Alacqua, Marianna
AU - Tran, Trung N.
AU - Suppli Ulrik, Charlotte
AU - Upham, John W.
AU - Wang, Eileen
AU - Bulathsinhala, Lakmini
AU - Carter, Victoria A.
AU - Chaudhry, Isha
AU - Eleangovan, Neva
AU - Murray, Ruth B.
AU - Price, Chris A.
AU - Price, David B.
N1 - Publisher Copyright:
© 2022 Menzies-Gow et al.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Biologics
KW - Cohort study
KW - International
KW - Management
KW - Prescribing
KW - Severe asthma
UR - http://www.scopus.com/inward/record.url?scp=85123856993&partnerID=8YFLogxK
U2 - 10.2147/JAA.S328653
DO - 10.2147/JAA.S328653
M3 - Journal article
C2 - 35046670
AN - SCOPUS:85123856993
VL - 15
SP - 63
EP - 78
JO - Journal of Asthma and Allergy
JF - Journal of Asthma and Allergy
SN - 1178-6965
ER -