Characteristics of patients with severe, uncontrolled, eosinophilic asthma enrolled in a French cohort

Abstract

Background and objectiveBenralizumab (Fasenra™) has recently been approved as add-on maintenance treatment for adult patients with severe eosinophilic asthma inadequately controlled despite high-dosage inhaled corticosteroids plus long-acting β2-agonists. We aimed to identify and describe the clinical characteristics and disease burden of patients with severe, uncontrolled, eosinophilic asthma in France who may be eligible for treatment with benralizumab.Patients and methodsThis was a retrospective analysis of a prospective, noninterventional, observational study of patients in France enrolled in the Asthma and Bronchial Obstruction Cohort (COBRA). First, we selected adult patients with severe asthma, a documented blood eosinophil count, 12 months of baseline data, and 12 months of follow-up data. Of these study-eligible patients, we next determined the prevalence and described the clinical characteristics and disease burden of patients who would be eligible to receive benralizumab, namely those with ≥2 asthma exacerbations in the previous 12 months and a blood eosinophil count ≥300/μL who were receiving high-dosage inhaled corticosteroids/long-acting β2-agonists.ResultsOf the 441 patients eligible for this study, 85 (19%) met the criteria for benralizumab therapy. At study inclusion, benralizumab-eligible patients had a smaller prebronchodilator forced expiratory volume in 1 second and less effective asthma control compared with benralizumab-ineligible patients. During the 12-month follow-up period, benralizumab-eligible patients had greater frequencies of asthma exacerbations and hospitalizations compared with benralizumab-ineligible patients.ConclusionOf patients with severe asthma, approximately 20% were qualified for benralizumab treatment. Benralizumab-eligible patients had increased bronchial obstruction, worse asthma control, and a greater frequency of asthma exacerbations and hospitalizations during follow-up care compared with benralizumab-ineligible patients, demonstrating inadequate disease control for these patients.

Trends and Disparities in Asthma Biologic Use in the United States

“…This study expands upon the previous finding of low overall omalizumab use by finding similar low utilization rates for the 4 more recently introduced asthma biologics (4). The percentage of individuals with severe asthma who would be eligible to use asthma biologics (7,8) is likely to be several times higher than the use rates we identified in this study. This suggests that asthma biologics are not being used by many individuals who have frequent exacerbations and would benefit by having them reduced.…”

A systematic literature review of burden of illness in adults with uncontrolled moderate/severe asthma

“…In 10 studies [37,51,70,72,78,87,[97][98][99][100] reporting the proportion of patients with any asthma-related exacerbation (i.e. moderate, severe, not-specified) at baseline, there was a wide range in the proportion of patients that experienced at least one exacerbation, from 14.9% (n = 737) [87] in patients with moderate/severe uncontrolled asthma initiating omalizumab to 100.0% (n = 25,935) [100] in patients with persistent asthma in a managed care setting.…”

“…The SLR identified 54 studies that reported asthma-related HCRU such as healthcare visits and hospitalisations [18,21,28,33,35,37,47,57,[59][60][61][62]65,[69][70][71][72][73]75,77,[86][87][88][89]92,93,95,97,98,[100][101][102]105,. Lack of asthma control despite treatment with ICS/LABA, and pre-treatment prior to omalizumab including with OCS, ICS, ICS/LABA, leukotriene receptor Fig.…”

Severe Asthma in a General Population Study: Prevalence and Clinical Characteristics

“…1,2 Those with severe asthma have more symptoms, exacerbations and comorbidities compared to those with mild-to-moderate asthma. [3][4][5] They also have lower asthma control, quality of life and lung function despite high doses of ICS. 3,[6][7][8] As the severity of asthma increases, so do the costs for society, 9,10 and severe uncontrolled asthma accounts for 60% of all asthma costs.…”