Abstract
Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life.
Methods
This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term366 oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance and hospital admissions.
Results
In the matched analysis (n=350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p372 experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs 20.55% reduction; p=0.023).) There was some evidence to suggest that patients treated with anti374 IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43).
Conclusions
In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes, however anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.
Original language | English |
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Number of pages | 15 |
Journal | Allergy |
Early online date | 27 Mar 2023 |
DOIs | |
Publication status | E-pub ahead of print - 27 Mar 2023 |
Bibliographical note
AcknowledgementsIn memory of Professor J. Mark Fitzgerald, the authors would like to acknowledge him for his valuable contribution to the development of the manuscript. The authors also acknowledge Ms. Daniela Morrone (MSc) of Cromsource, Verona, Italy for her contribution during the development of the manuscript and Mr. Joash Tan (BSc, Hons) of the Observational and Pragmatic Research Institute (OPRI), for editorial and formatting assistance that supported the development of this publication.
Funding information
This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.
Keywords
- biologics
- exacerbation
- ISAR
- real life
- oral corticosteroids