Susanne Hansen, Ming-Ju Tsai, Trung N Tran, John D Blakey, Benjamin Emmanuel, Shawn D Aaron, Yahya Habis, Valeria Perugini, Alan Altraja, Rohit K Katial, Luis Perez-de-Llano, Paul E Pfeffer, Nikolaos G Papadopoulos, John Townend, Ghislaine Scelo, Aaron Beastall, Lakmini Bulathsinhala, John Busby, Andrew W Lindsley, Wendy C Moore, Reynold A Panettieri, Giorgio Walter Canonica, Enrico Heffler, Cristina Cardini, Giuseppe Guida, Celeste M Porsbjerg, Anne-Sofie Bjerrum, Anna Von Bülow, Ole Hilberg, Kjell Erik Julius Håkansson, Marianne Baastrup Soendergaard, Charlotte Suppli Ulrik, Eileen Wang, Michael E Wechsler, Nicholas Chapman, Flavia C L Hoyte, Kanao Otsu, Liam G Heaney, David J Jackson, Pujan H Patel, Dermot Ryan, Celine Bergeron, Shelley Abercromby, Mohit Bhutani, Kenneth R Chapman, Andréanne Côté, Beth E Davis, Delbert R Dorscheid, Leiana Hoshyari, Brianne Philipenko, Hana Serajeddini, Florence Schleich, Renaud Louis, Piotr Kuna, Borja G Cosio, Désirée Larenas-Linnemann, Carlos A Torres-Duque, María José Fernández-Sánchez, Elizabeth Garcia, Fabio Bolívar-Grimaldos, Libardo Jiménez-Maldonado, Diana Jimena Cano-Rosales, Ivan Solarte, Riyad Al-Lehebi, Adeeb A Bulkhi, Mona Al-Ahmad, Takashi Iwanaga, Soichiro Hozawa, Hisako Matsumoto, Tatsuya Nagano, Tomoko Tajiri, Bernt Bøgvald Aarli, Diahn-Warng Perng, Yi-Han Hsiao, Pin-Kuei Fu, Chau-Chyun Sheu, Konstantinos Kostikas, Mina Gaga, Athena Gogali, Maria Kallieri, Stelios Loukides, Michael Makris, Maria Dimosthenis Ntakoula, Andriana I Papaioannou, Giannis Paraskevopoulos, Fotios Psarros, Bassam Mahboub, Laila Salameh, Mariko Siyue Koh, Mei Fong Liew, Pee Hwee Pang, Tze Lee Tan, Tunn Ren Tay, Paulo Márcio Pitrez, Chin Kook Rhee, Njira Lugogo, Arjun Mohan, João A Fonseca, Ana Alves da Silva, Cláudia Chaves Loureiro, Hadassa Cristhina de Azevedo Soares Dos Santos, Jorge Fernando Máspero, Ledit R F Ardusso, María Eugenia Franchi, Martin Sivori, Ana María Stok, Anahí Yañez, George Christoff, Todor A Popov, Patrick D Mitchell, Sundeep Santosh Salvi, Richard W Costello, Eve Denton, Mark Hew, Christine R Jenkins, David Langton, Peter G Middleton, Matthew J Peters, Lauri Lehtimäki, Arnaud Bourdin, Camille Taillé, Christian Taube, Zsuzsanna Csoma, Dóra Lúdvíksdóttir, Job F M van Boven, James Fingleton, Leif Bjermer, Helena Emery, Graham Lough, Roy Alton Pleasants, Diego J Maselli, Christopher S Ambrose, Cathy Emmas, Andrew N Menzies-Gow, Victoria Carter, Nevaashni Eleangovan, Ruth B Murray, Chris A Price, Mohsen Sadatsafavi, David B Price, ISAR GLEAM Working Group, ISAR GLEAM Working Group, List of ISAR collaborators, List of CHRONICLE collaborators, ISAR GLEAM Working Group, List of ISAR collaborators, List of CHRONICLE collaborators
Easier access to biologics for patients with SA, a prerequisite for shorter time-to-initiation, was associated with a greater probability of achieving clinical remission and other favorable asthma outcomes. Initiating biologics earlier in the asthma disease course may help unlock greater therapeutic potential in SA. These findings warrant confirmation in additional studies to further establish the causal relationship between biologic accessibility, timing of initiation, and clinical outcomes in SA.
PURPOSE: Time to biologic initiation for the treatment of severe asthma (SA) is affected by many factors, including ease of access to biologics, which is often subject to approval by regulatory authorities and reimbursement criteria by relevant agencies. We investigated the association between ease of biologic access (using the biologic accessibility score [BACS] as a proxy) and post-biologic asthma outcomes, including remission.
METHODS: This ecological study, using data from CHRONICLE (a US severe asthma registry), the International Severe Asthma Registry (ISAR), and the Optimum Patient Care Research Database (OPCRD), included patients with SA from 21 countries. Associations at the country level, between BACS, a composite score of prescription criteria for biologics in SA, and the proportion of patients with a favorable asthma outcome 1-year post-biologic in each setting (ie ISAR country or in the CHRONICLE or OPCRD datasets) were tested. Several definitions of favorable outcome were used, including proportion of patients who achieved clinical remission (defined using 2, 3 and 4 domains), experienced no exacerbations, had well- or partly controlled asthma, a percent predicted forced expiratory volume in 1 second (ppFEV1) or percent predicted peak expiratory flow rate (ppPEFR) ≥80%, and no long-term oral corticosteroid (LTOCS) use.
RESULTS: A total of 9,183 patients were included. A higher BACS (as a proxy of easier access to biologics) was associated with a higher likelihood of achieving clinical remission (p≤0.001), no exacerbations (p<0.001), well- or partly controlled asthma (p=0.047), a ppFEV1 or ppPEFR ≥80% (p=0.004), and no need for LTOCS (p=0.045) 1 year post-biologic initiation.
CONCLUSION: Easier access to biologics for patients with SA, a prerequisite for shorter time-to-initiation, was associated with a greater probability of achieving clinical remission and other favorable asthma outcomes. Initiating biologics earlier in the asthma disease course may help unlock greater therapeutic potential in SA. These findings warrant confirmation in additional studies to further establish the causal relationship between biologic accessibility, timing of initiation, and clinical outcomes in SA.