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Journal of Asthma and Allergy Volume 15, 2022 - Issue
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ORIGINAL RESEARCH

Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy

Wenjia Chen1 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, SingaporeView further author information
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Mohsen Sadatsafavi2 Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, CanadaORCID Iconhttps://orcid.org/0000-0002-0419-7862View further author information
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Trung N Tran3 AstraZeneca, Gaithersburg, MD, USAView further author information
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Ruth B Murray4 Optimum Patient Care, Cambridge, UKView further author information
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Chong Boon Nigel Wong1 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, SingaporeORCID Iconhttps://orcid.org/0000-0002-6501-8848View further author information
ORCID Icon,
Nasloon Ali4 Optimum Patient Care, Cambridge, UK;5 Observational and Pragmatic Research Institute, Singapore, SingaporeORCID Iconhttps://orcid.org/0000-0001-9585-0232View further author information
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Cono Ariti4 Optimum Patient Care, Cambridge, UK;5 Observational and Pragmatic Research Institute, Singapore, SingaporeView further author information
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Esther Garcia Gil6 AstraZeneca, Barcelona, SpainView further author information
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Anthony Newell5 Observational and Pragmatic Research Institute, Singapore, Singapore;7 Optimum Patient Care, Queensland, VIC, AustraliaORCID Iconhttps://orcid.org/0000-0001-6871-1392View further author information
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Marianna Alacqua8 AstraZeneca, Cambridge, UKView further author information
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Mona Al-Ahmad9 Microbiology Department, Faculty of Medicine, Kuwait University, Al-Rashed Allergy Center, Ministry of Health, Kuwait City, KuwaitORCID Iconhttps://orcid.org/0000-0003-2950-5363View further author information
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Alan Altraja10 Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, EstoniaView further author information
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Riyad Al-Lehebi11 Department of Pulmonology, King Fahad Medical City, Riyadh, Saudi Arabia;12 College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaORCID Iconhttps://orcid.org/0000-0002-3232-6668View further author information
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Mohit Bhutani13 Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Western Canada, AB, CanadaView further author information
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Leif Bjermer14 Department of Clinical Sciences, Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, SwedenORCID Iconhttps://orcid.org/0000-0002-3441-8099View further author information
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Anne Sofie Bjerrum15 Department of Respiratory Medicine and Allergy, Aarhus University Hospital, Jutland, Aarhus, DenmarkView further author information
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Arnaud Bourdin16 PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, FranceORCID Iconhttps://orcid.org/0000-0002-4645-5209View further author information
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Lakmini Bulathsinhala4 Optimum Patient Care, Cambridge, UK;5 Observational and Pragmatic Research Institute, Singapore, SingaporeView further author information
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Anna von Bülow17 Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, DenmarkView further author information
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John Busby18 Centre for Public Health, Queen’s University Belfast, Belfast, Northern IrelandView further author information
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Giorgio Walter Canonica19 Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy;20 Department of Biomedical Sciences, Humanitas University, Milan, ItalyORCID Iconhttps://orcid.org/0000-0001-8467-2557View further author information
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Victoria Carter4 Optimum Patient Care, Cambridge, UK;5 Observational and Pragmatic Research Institute, Singapore, SingaporeView further author information
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George C Christoff21 Medical University-Sofia, Faculty of Public Health, Sofia, BulgariaORCID Iconhttps://orcid.org/0000-0003-4549-7711View further author information
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Borja G Cosio22 Son Espases University Hospital-IdISBa-Ciberes, Mallorca, SpainORCID Iconhttps://orcid.org/0000-0002-6388-8209View further author information
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Richard W Costello23 Department of Respiratory Medicine, Clinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, IrelandORCID Iconhttps://orcid.org/0000-0003-1179-6692View further author information
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J Mark FitzGerald24 Department of Medicine, the University of British Columbia, Vancouver, BC, CanadaView further author information
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João A Fonseca25 Comunity Health, Information and Decision Sciences Department (MEDCIDS) & Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of University of Porto, Porto, PortugalView further author information
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Kwang Ha Yoo26 KonKuk University School of Medicine in Seoul, Seoul, KoreaORCID Iconhttps://orcid.org/0000-0001-9969-2657View further author information
ORCID Icon,
Liam G Heaney27 Wellcome-Wolfson Centre for Experimental Medicine, Queen’s University Belfast, Belfast, Northern IrelandView further author information
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Enrico Heffler19 Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy;20 Department of Biomedical Sciences, Humanitas University, Milan, ItalyView further author information
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Mark Hew28 Allergy, Asthma & Clinical Immunology Service, Alfred Health, Melbourne, VIC, Australia;29 Public Health and Preventive Medicine, Monash University, Melbourne, VIC, AustraliaView further author information
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Ole Hilberg30 Medical Department, Vejle University Hospital, Jutland, Vejle, DenmarkORCID Iconhttps://orcid.org/0000-0002-3075-3463View further author information
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Flavia Hoyte31 Department of Medicine, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, CO, USA;32 Department of Internal Medicine, Division of Allergy & Clinical Immunology, University of Colorado School of Medicine, Aurora, CO, USAView further author information
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Takashi Iwanaga33 Center for General Medical Education and Clinical Training, Kindai University Hospital, Osakasayama, JapanORCID Iconhttps://orcid.org/0000-0001-9155-265XView further author information
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David J Jackson34 UK Severe Asthma Network and National Registry, Guy’s and St Thomas’ NHS Trust, London, UK;35 School of Immunology & Microbial Sciences, King’s College London, London, UKView further author information
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Rupert C Jones36 Research and Knowledge Exchange, Plymouth Marjon University, Plymouth, UKORCID Iconhttps://orcid.org/0000-0002-5463-2981View further author information
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Mariko Siyue Koh37 Respiratory & Critical Care Medicine, Singapore General Hospital, Singapore, Singapore;38 SingHealth Duke-NUS Lung Centre, Singapore, SingaporeView further author information
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Piotr Kuna39 Division of Internal Medicine, Asthma and Allergy Medical University of Łódź, Łódź, PolandView further author information
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Désirée Larenas-Linnemann40 Directora Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Ciudad de México, MexicoORCID Iconhttps://orcid.org/0000-0002-5713-5331View further author information
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Sverre Lehmann41 Section of Thoracic Medicine, Department of Clinical Science, University of Bergen, Bergen, NorwayView further author information
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Lauri A Lehtimäki42 Allergy Centre, Tampere University Hospital, Tampere, Finland;43 Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandORCID Iconhttps://orcid.org/0000-0003-1586-4998View further author information
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Juntao Lyu5 Observational and Pragmatic Research Institute, Singapore, Singapore;7 Optimum Patient Care, Queensland, VIC, AustraliaORCID Iconhttps://orcid.org/0000-0003-0465-4784View further author information
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Bassam Mahboub44 College of Medicine, University of Sharjah, Sharjah, United Arab Emirates;45 Rashid Hospital, Dubai Health Authority, Dubai, United Arab EmiratesView further author information
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Jorge Maspero46 Clinical Research for Allergy and Respiratory Medicine, CIDEA Foundation, Buenos Aires, Argentina;47 University Career of Specialists in Allergy and Clinical Immunology at the Buenos Aires University School of Medicine, Buenos Aires, ArgentinaView further author information
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Andrew N Menzies-Gow48 Royal Brompton & Harefield Hospitals, London, UKView further author information
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Concetta Sirena49 Severe Asthma Network in Italy (SANI), Milano, ItalyView further author information
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Nikolaos Papadopoulos50 Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK;51 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, GreeceORCID Iconhttps://orcid.org/0000-0002-4448-3468View further author information
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Andriana I Papaioannou52 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, GreeceORCID Iconhttps://orcid.org/0000-0001-9708-3241View further author information
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Luis Pérez de Llano53 Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Lugo, Spain;54 Biodiscovery Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, SpainORCID Iconhttps://orcid.org/0000-0003-2652-6847View further author information
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Diahn-Warng Perng55 Division of Clinical Respiratory Physiology Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan;56 COPD Assembly of the Asian Pacific Society of RespirologyHongo, Bunkyo-ku, Tokyo, JapanView further author information
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Matthew Peters57 Department of Thoracic Medicine, Concord Hospital, Sydney, NSW, AustraliaView further author information
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Paul E Pfeffer58 Department of Respiratory Medicine, Barts Health NHS Trust, London, UK;59 Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UKView further author information
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Celeste M Porsbjerg17 Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, DenmarkView further author information
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Todor A Popov60 University Hospital ”sv. Ivan Rilski”, Sofia, BulgariaORCID Iconhttps://orcid.org/0000-0001-5052-5866View further author information
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Chin Kook Rhee61 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, South KoreaView further author information
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Sundeep Salvi62 Pulmocare Research and Education Foundation, Pune, IndiaView further author information
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Camille Taillé63 Department of Respiratory Diseases, Bichat Hospital, AP-HP Nord-Université de Paris, Paris, FranceView further author information
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Christian Taube64 Department of Pulmonary Medicine, University Medical Center Essen-Ruhrlandklinik, Essen, GermanyView further author information
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Carlos A Torres-Duque65 CINEUMO, Respiratory Research Center, Fundación Neumológica Colombiana, Bogotá, ColombiaORCID Iconhttps://orcid.org/0000-0003-0004-8955View further author information
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Charlotte S Ulrik66 Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, DenmarkORCID Iconhttps://orcid.org/0000-0001-8689-3695View further author information
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Seung Won Ra67 Department of Internal Medicine, Division of Pulmonology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South KoreaORCID Iconhttps://orcid.org/0000-0002-2458-8414View further author information
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Eileen Wang31 Department of Medicine, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, CO, USA;32 Department of Internal Medicine, Division of Allergy & Clinical Immunology, University of Colorado School of Medicine, Aurora, CO, USAView further author information
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Michael E Wechsler68 Department of Medicine, NJH Cohen Family Asthma Institute, National Jewish Health, Denver, CO, USAORCID Iconhttps://orcid.org/0000-0003-3505-2946View further author information
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David B Price4 Optimum Patient Care, Cambridge, UK;5 Observational and Pragmatic Research Institute, Singapore, Singapore;69 Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-9728-9992View further author information
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Pages 1491-1510 | Received 24 Jun 2022, Accepted 23 Sep 2022, Published online: 21 Oct 2022

Figures & data

Figure 1 Flowchart of cohort creation.

Figure 1 Flowchart of cohort creation.

Figure 2 Geographic distribution of adult severe asthma patients with high oral corticosteroid exposure enrolled in ISAR according to biologic initiation status. ISAR: International Severe Asthma Registry. Data are presented as % not initiated/% initiated. Green: approximately equal proportion of biologic non-initiators to initiators; Blue: More likely not to initiate biologics; Yellow: more likely to initiate biologics.

Figure 2 Geographic distribution of adult severe asthma patients with high oral corticosteroid exposure enrolled in ISAR according to biologic initiation status. ISAR: International Severe Asthma Registry. Data are presented as % not initiated/% initiated. Green: approximately equal proportion of biologic non-initiators to initiators; Blue: More likely not to initiate biologics; Yellow: more likely to initiate biologics.

Table 1 Baseline Demographic Characteristics for ISAR Patients with Severe Asthma and High Oral Corticosteroid Exposure Who Were and Were Not Initiated on Biologic (Bx) Therapy

Table 2 Baseline Clinical Characteristics for ISAR Patients with Severe Asthma and High Oral Corticosteroid Exposure Who Were and Were Not Initiated on Biologic (Bx) Therapy

Figure 3 Clinical characteristics of adult severe asthma patients with high oral corticosteroid exposure enrolled in ISAR who did and did not initiate biologic therapy.

Abbreviations: BEC, blood eosinophil count; BD, bronchodilator; Bx, biologic; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; IgE, immunoglobulin E; ISAR, International Severe Asthma Registry; OCS, oral corticosteroid.
Figure 3 Clinical characteristics of adult severe asthma patients with high oral corticosteroid exposure enrolled in ISAR who did and did not initiate biologic therapy.

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