TY - JOUR

T1 - Heterogeneity in the use of biologics for severe asthma in Europe

T2 - a SHARP ERS study

AU - Frix, Anne Noelle

AU - Heaney, Liam G.

AU - Dahlén, Barbro

AU - Mihaltan, Florin

AU - Sergejeva, Svetlana

AU - Popović-Grle, Sanja

AU - Sedlak, Vratislav

AU - Lehtimäki, Lauri

AU - Bourdin, Arnaud

AU - Korn, Stephanie

AU - Zervas, Eleftherios

AU - Csoma, Zsuzsanna

AU - Lúðvíksdóttir, Dora

AU - Butler, Marcus

AU - Canonica, Giorgio Walter

AU - Grisle, Ineta

AU - Bieksiene, Kristina

AU - Ten Brinke, Anneke

AU - Kuna, Piotr

AU - Loureiro, Claudia Chaves

AU - Nenasheva, Natalia M.

AU - Lazic, Zorica

AU - Škrgat, Sabina

AU - Ramos-Barbon, David

AU - Leuppi, Joerg

AU - Gemicioglu, Bilun

AU - Bossios, Apostolos

AU - Porsbjerg, Celeste M.

AU - Bel, Elisabeth H.

AU - Djukanovic, Ratko

AU - Louis, Renaud

N1 - Publisher Copyright: © The authors 2022.

PY - 2022

Y1 - 2022

N2 - Introduction Treatment with biologics for severe asthma is informed by international and national guidelines and defined by national regulating bodies, but how these drugs are used in real-life is unknown. Materials and methods The European Respiratory Society (ERS) SHARP Clinical Research Collaboration conducted a three-step survey collecting information on asthma biologics use in Europe. Five geographically distant countries defined the survey questions, focusing on seven end-points: biologics availability and financial issues, prescription and administration modalities, inclusion criteria, continuation criteria, switching biologics, combining biologics and evaluation of corticosteroid toxicity. The survey was then sent to SHARP National Leads of 28 European countries. Finally, selected questions were submitted to a broad group of 263 asthma experts identified by national societies. Results Availability of biologics varied between countries, with 17 out of 28 countries having all five existing biologics. Authorised prescribers (pulmonologists and other specialists) also differed. In-hospital administration was the preferred deliverance modality. While exacerbation rate was used as an inclusion criterion in all countries, forced expiratory volume in 1 s was used in 46%. Blood eosinophils were an inclusion criterion in all countries for interleukin-5 (IL-5)-targeted and IL-4/IL-13-targeted biologics, with varying thresholds. There were no formally established criteria for continuing biologics. Reduction in exacerbations represented the most important benchmark, followed by improvement in asthma control and quality of life. Only 73% (191 out of 263) of surveyed clinicians assessed their patients for corticosteroid-induced toxicity. Conclusion Our study reveals important heterogeneity in the use of asthma biologics across Europe. To what extent this impacts on clinical outcomes relevant to patients and healthcare services needs further investigation.

AB - Introduction Treatment with biologics for severe asthma is informed by international and national guidelines and defined by national regulating bodies, but how these drugs are used in real-life is unknown. Materials and methods The European Respiratory Society (ERS) SHARP Clinical Research Collaboration conducted a three-step survey collecting information on asthma biologics use in Europe. Five geographically distant countries defined the survey questions, focusing on seven end-points: biologics availability and financial issues, prescription and administration modalities, inclusion criteria, continuation criteria, switching biologics, combining biologics and evaluation of corticosteroid toxicity. The survey was then sent to SHARP National Leads of 28 European countries. Finally, selected questions were submitted to a broad group of 263 asthma experts identified by national societies. Results Availability of biologics varied between countries, with 17 out of 28 countries having all five existing biologics. Authorised prescribers (pulmonologists and other specialists) also differed. In-hospital administration was the preferred deliverance modality. While exacerbation rate was used as an inclusion criterion in all countries, forced expiratory volume in 1 s was used in 46%. Blood eosinophils were an inclusion criterion in all countries for interleukin-5 (IL-5)-targeted and IL-4/IL-13-targeted biologics, with varying thresholds. There were no formally established criteria for continuing biologics. Reduction in exacerbations represented the most important benchmark, followed by improvement in asthma control and quality of life. Only 73% (191 out of 263) of surveyed clinicians assessed their patients for corticosteroid-induced toxicity. Conclusion Our study reveals important heterogeneity in the use of asthma biologics across Europe. To what extent this impacts on clinical outcomes relevant to patients and healthcare services needs further investigation.

U2 - 10.1183/23120541.00273-2022

DO - 10.1183/23120541.00273-2022

M3 - Journal article

C2 - 36299366

AN - SCOPUS:85140483184

VL - 8

JO - ERJ Open Research

JF - ERJ Open Research

SN - 2312-0541

IS - 4

M1 - 00273-2022

ER -