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 -