A Retrospective Claims Database Study to Clarify Disease Burden of Severe Asthma Patients with Type 2 High or Low Inflammation

Abstract

Purpose

The disease burden of severe asthma patients stratified by type 2 (T2) biomarkers is not well studied in large patient samples, especially for T2-low severe asthma patients. Using a Japanese medical record database, we investigated disease and economic burdens in T2-high and T2-low severe asthma patients.

Patients and Methods

Data of severe asthma patients (receiving high-dose inhaled corticosteroids and additional asthma-related controller medications or oral corticosteroids [OCS] prescription [≥183 days] during the 1-year baseline period) were analyzed in the Real World Data database, comprising electronic medical records from Japanese medical institutions. Severe asthma patients were stratified into a T2-high population with higher eosinophils (≥150 cells/μL) and/or higher total immunoglobulin E (IgE, ≥75 IU/mL) or a T2-low population with lower eosinophils (<150 cells/μL) and lower total IgE (<75 IU/mL). The incidence of asthma exacerbation events and drug costs were analyzed for each population. Different T2 thresholds were explored, including eosinophil count 300 cells/μL and/or IgE 150 IU/mL.

Results

Of the 732 severe asthma patients, 599 (81.8%) patients had T2-high type, and 133 (18.2%) had T2-low type. Proportions of the T2-high patients (30.6%) with asthma exacerbations, defined as a composite outcome, including OCS burst, injectable steroid use, and hospitalization, were similar to those of T2-low type (34.6%). The annual drug cost was similar between T2-high (175,487 JPY) and T2-low (165,322 JPY) populations.

Conclusion

In this large-scale study, both T2-high and T2-low severe asthma patients in Japan were shown to have a high disease burden and high economic burden, suggesting an unmet treatment need.

Keywords:

• phenotype
• disease exacerbation
• treatment
• Japan

Acknowledgments

The authors thank the Health, Clinic, and Education Information Evaluation Institute for developing the database used for the study. The authors also thank EP Croit Inc. for conducting the data analyses, which were funded by AstraZeneca K.K., Osaka, Japan. In addition the authors thank Keyra Martinez Dunn, MD, of Edanz, Japan, for providing medical writing support, which was funded by AstraZeneca K.K., Japan, through EMC K.K., Japan, in accordance with Good Publication Practice (GPP 2022) guidelines (https://www.ismpp.org/gpp-2022).

Disclosure

NH has received honoraria from AstraZeneca K.K., GlaxoSmithKline K.K., Novartis Pharma K.K., and Sanofi K.K., and grants from AstraZeneca K.K., Daikin (CHINA) Investment Co., Ltd., Kao Corporation, Kyorin Pharmaceutical Co., Ltd., SRL Medisearch Inc., and Tosoh Corporation, outside the submitted work. NM, KF, KN, KO, and NT are employees of AstraZeneca K.K. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by AstraZeneca K.K., Osaka, Japan. AstraZeneca K.K. participated in the study design, analysis, and interpretation of data, writing the report, and deciding to submit the article for publication.