Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)

Wang Eileen, Michael E Wechsler, Trung N Tran, Liam G Heaney, Rupert C Jones, Andrew N Menzies-Gow, John Busby, David J Jackson, Paul E Pfeffer, Chin Kook Rhee, You Sook Cho, G Walter Canonica, Enrico Heffler, Peter G Gibson, Mark Hew, Matthew Peters, Erin S Harvey, Mariana Alacqua, James Zangrilli, Lakmini BulathsinhalaVictoria A Carter, Isha Chaudhry, Neva Eleangovan, Naeimeh Hosseini, Ruth B Murray, David B Price*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.

METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.

RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.

CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

Original languageEnglish
Number of pages43
JournalChest
Early online date27 Nov 2019
DOIs
Publication statusE-pub ahead of print - 27 Nov 2019

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Registries
Asthma
Demography
Republic of Korea
Singapore
Biological Products
New Zealand
Age of Onset
Italy
Therapeutics
Biomarkers
Phenotype
Weights and Measures
Population

Keywords

  • biologics
  • co-morbidity
  • eosinophils
  • FeNO
  • IgE

Cite this

Characterization of severe asthma worldwide : data from the International Severe Asthma Registry (ISAR). / Eileen, Wang; Wechsler, Michael E; Tran, Trung N; Heaney, Liam G; Jones, Rupert C; Menzies-Gow, Andrew N; Busby, John; Jackson, David J; Pfeffer, Paul E; Rhee, Chin Kook; Cho, You Sook; Canonica, G Walter; Heffler, Enrico; Gibson, Peter G; Hew, Mark; Peters, Matthew; Harvey, Erin S; Alacqua, Mariana; Zangrilli, James; Bulathsinhala, Lakmini; Carter, Victoria A; Chaudhry, Isha; Eleangovan, Neva; Hosseini, Naeimeh; Murray, Ruth B; Price, David B.

In: Chest, 27.11.2019.

Research output: Contribution to journalArticle

Eileen, W, Wechsler, ME, Tran, TN, Heaney, LG, Jones, RC, Menzies-Gow, AN, Busby, J, Jackson, DJ, Pfeffer, PE, Rhee, CK, Cho, YS, Canonica, GW, Heffler, E, Gibson, PG, Hew, M, Peters, M, Harvey, ES, Alacqua, M, Zangrilli, J, Bulathsinhala, L, Carter, VA, Chaudhry, I, Eleangovan, N, Hosseini, N, Murray, RB & Price, DB 2019, 'Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)', Chest. https://doi.org/10.1016/j.chest.2019.10.053
Eileen, Wang ; Wechsler, Michael E ; Tran, Trung N ; Heaney, Liam G ; Jones, Rupert C ; Menzies-Gow, Andrew N ; Busby, John ; Jackson, David J ; Pfeffer, Paul E ; Rhee, Chin Kook ; Cho, You Sook ; Canonica, G Walter ; Heffler, Enrico ; Gibson, Peter G ; Hew, Mark ; Peters, Matthew ; Harvey, Erin S ; Alacqua, Mariana ; Zangrilli, James ; Bulathsinhala, Lakmini ; Carter, Victoria A ; Chaudhry, Isha ; Eleangovan, Neva ; Hosseini, Naeimeh ; Murray, Ruth B ; Price, David B. / Characterization of severe asthma worldwide : data from the International Severe Asthma Registry (ISAR). In: Chest. 2019.
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abstract = "BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3{\%}), white (72.6{\%}), had never smoked (60.5{\%}) and were over-weight/obese (70.4{\%}). 34.9{\%} were on GINA Step 5. 57.2{\%} had poorly controlled disease. 51.1{\%} of patients were on regular intermittent OCS and 25.4{\%} were on biologics (72.6{\%} for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.",
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T1 - Characterization of severe asthma worldwide

T2 - data from the International Severe Asthma Registry (ISAR)

AU - Eileen, Wang

AU - Wechsler, Michael E

AU - Tran, Trung N

AU - Heaney, Liam G

AU - Jones, Rupert C

AU - Menzies-Gow, Andrew N

AU - Busby, John

AU - Jackson, David J

AU - Pfeffer, Paul E

AU - Rhee, Chin Kook

AU - Cho, You Sook

AU - Canonica, G Walter

AU - Heffler, Enrico

AU - Gibson, Peter G

AU - Hew, Mark

AU - Peters, Matthew

AU - Harvey, Erin S

AU - Alacqua, Mariana

AU - Zangrilli, James

AU - Bulathsinhala, Lakmini

AU - Carter, Victoria A

AU - Chaudhry, Isha

AU - Eleangovan, Neva

AU - Hosseini, Naeimeh

AU - Murray, Ruth B

AU - Price, David B

PY - 2019/11/27

Y1 - 2019/11/27

N2 - BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

AB - BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

KW - biologics

KW - co-morbidity

KW - eosinophils

KW - FeNO

KW - IgE

U2 - 10.1016/j.chest.2019.10.053

DO - 10.1016/j.chest.2019.10.053

M3 - Article

C2 - 31785254

JO - Chest

JF - Chest

SN - 0012-3692

ER -