Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Biological therapies have revolutionized the treatment of severe asthma with type 2 inflammation. Although such treatments are very effective in reducing exacerbation and the dose of oral steroids, little is known about the persistence of symptoms in severe asthma patients treated with biologics. PURPOSE: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics. DESIGN: 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.
Authors: Laurent Guilleminault, Claire Camus, Chantal Raherison-Semjen, Audrey Capdepon, Arnaud Bourdin, Philippe Bonniaud, Stéphanie Fry, Gilles Devouassoux, François-Xavier Blanc, Christophe Pison, Clairelyne Dupin, Naji Khayath, Joelle Courdeau, Judith Valcke-Brossollet, Cécilia Nocent-Ejnaini, Fabien Rolland, Carmen Lamandi, Alain Proust, Anaig Ozier, Laurent Portel, Wanda Gaspard, Pauline Roux-Claude, Antoine Beurnier, Stéphanie Martinez, Jean-Marc Dot, Florence Hennegrave, Guillaume Vignal, Etienne Auvray, Nicolas Paleiron, Nicolas Just, Jean Miltgen, Maud Russier, Cécile Olivier, Camille Taillé, Alain Didier
Institutions: Centre National de la Recherche Scientifique, Inserm, Centre Hospitalier Universitaire de Toulouse, French Clinical Research Infrastructure Network, Institut Toulousain des Maladies Infectieuses et Inflammatoires, Université de Toulouse, Université des Antilles, AstraZeneca (France), Centre Hospitalier Universitaire de Montpellier, CHU Dijon Bourgogne, Centre Hospitalier Universitaire de Lille, Hospices Civils de Lyon, Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Nantes Université, Centre Hospitalier Universitaire de Grenoble, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Hôpitaux Universitaires de Strasbourg, Centre Hospitalier de Bigorre, Centre Hospitalier de la Côte Basque, Centre Hospitalier de Cannes, Groupe Hospitalier de la Région de Mulhouse et Sud Alsace, Centre Hospitalier Universitaire de Nîmes, Hôpital d'instruction des Armées Percy, Centre Hospitalier Universitaire de Besançon, Hôpital Ambroise-Paré, Bicêtre Hospital, Centre Hospitalier Intercommunal Aix-Pertuis, Centre Hospitalier De Pau, Centre Hospitalier Métropole Savoie, Centre Hospitalier de Roubaix, Centre hospitalier universitaire d'Orléans
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,300
OpenAlex ID: W4388699593