Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study

Izquierdo, José Luis; Almonacid, Carlos; Campos, Camila Gonçalves de; Morena, Diego; Benavent, Manuel Oltra; González-de-Olano, David; Rodríguez, J.M. Montes

doi:10.18176/jiaci.0765

Cited by 13 publications

(14 citation statements)

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“…Taube et al [23], found a prevalence of severe asthma of 7.3%, among which 33.6% were OCSdependent. Izquierdo et al [24] highlighted the frequently use of OCS in Spain (ranging from 31.4% in 2015 to 39.6% in 2019). BRAVO-1 also showed that 1 out of 43 asthma patients are corticodependent.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, T2 Biomarkers, and Cost of Severe Asthma in the Era of Biologics: The BRAVO-1 Study

Domingo¹,

Sicras-Mainar²,

Sicras-Navarro³

et al. 2024

J Investig Allergol Clin Immunol

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Background: The last decade has seen a new era of classifications of asthma pathophysiology which have changed the treatment options available. Objectives: To update the figures of prevalence of T2 asthma, comorbidities, biomarker characterization and costs of severe asthma in patients≥12-years-old adapted to this new situation. Methods: Retroprospective, observational, nationwide study using a top-down approach. Data were obtained from the BIG-PAC®, an electronic medical record database of 1.7 million patients in Spain. Patients≥12-years-old who had received medical care during the period 2016-2017 and diagnosed with asthma at least one year prior to the index date were included and followed for one year. Results: Prevalence of asthma was 5.5%. Of these patients, asthma was severe in 3.031 (7.7%), 81.2% of whom presented T2 asthma. Among severe asthma patients, 64·1% were uncontrolled, 31.2% were Oral corticosteroids-dependent (37% in the uncontrolled severe asthma group) and only 3.8% were on biologics. The most common T2 comorbidities were allergic rhinitis (66·1%), atopic dermatitis (29·1%) and chronic rhinositis with nasal polyps (14.6%). Mortality rates in the total and the uncontrolled severe asthma groups were 4.2% and 5.5% respectively. The total annual costs per patient with severe asthma were 5.890€ (uncontrolled) and 2.841€ (controlled). Conclusions: In the era of biologics, most severe asthma patients present T2 asthma. Despite the availability of new treatments, the rates of uncontrolled and oral corticosteroids-dependent patients with severe asthma remain high, but biologics still underused. The costs of uncontrolled severe asthma are twice as high as those of controlled severe asthma.

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Section: Discussionmentioning

confidence: 99%

Prevalence, T2 Biomarkers, and Cost of Severe Asthma in the Era of Biologics: The BRAVO-1 Study

Domingo¹,

Sicras-Mainar²,

Sicras-Navarro³

et al. 2024

J Investig Allergol Clin Immunol

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“…Finally, the presence of certain allergens in the air could also have an influence on the higher OCS use in Asturias, Galicia and some areas of the south of Spain. Another study recently published in Spain has shown a heterogeneity between prescribing OCS by primary care physicians, pulmonologists, and allergists [ 32 ]. OCS were prescribed mainly in primary care (59%), allergy (13%), and pulmonology (20%).…”

Section: Discussionmentioning

confidence: 99%

“…Another interesting piece of data from the same study is the analysis of OCS consumption by year in the period from 2015 to 2019. The data showed that between 31.4 and 39.6% of the overall population of patients with asthma had received at least one cycle of OCS depending on the year analyzed [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses

et al. 2023

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Background Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. Methods This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 “asthma” and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled β2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. Results Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25–Pc75) since asthma diagnosis was 83.1 months (34.65–131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. Conclusions There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control.

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“…The accuracy of this system has already been verified in different studies by comparing EHRead ® 's output with a reference or 'studyspecific gold standard', which consists of a set of EHRs annotated manually by expert physicians. 38,[43][44][45] External evaluation of data retrieval In order to evaluate system's accuracy when identifying EHRs containing mentions of study-related variables, an analysis comparing SAVANA EHRead ® output with physicians' annotations was carried out. Medical experts together with NLP experts selected the sample of 14 variables for assessment that was representative for the study (SpA, PsA, AxSpA, AS, DAPSA, ASDAS, BASDAI, dactylitis, C reactive protein, enthesitis, etanercept, infliximab, SEC, and adalimumab).…”

Section: Data Sourcementioning

confidence: 99%

Using natural language processing to explore characteristics and management of patients with axial spondyloarthritis and psoriatic arthritis treated under real-world conditions in Spain: SpAINET study

Benavent,

Muñoz-Fernández,

De la Morena

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: Spondyloarthritis (SpA) is a group of related but phenotypically distinct inflammatory disorders that include axial SpA (axSpA) and psoriatic arthritis (PsA). Information on the characteristics and management of these patients in the real world remains scarce. Objectives: To explore the characteristics and management [disease activity assessment and treatment with secukinumab (SEC) or other biologic disease-modifying antirheumatic drugs (bDMARDs)] of axSpA and PsA patients using natural language processing (NLP) in Electronic Health Records (EHRs). Design: National, multicenter, observational, and retrospective study. Methods: We analyzed free-text and structured clinical information from EHR at three hospitals. All adult patients with axSpA, PsA or non-classified SpA from 2018 to 2021 with minimum follow-up of three months were included when starting SEC or other bDMARDs. Clinical variables were extracted using EHRead® technology based on Systemized Nomenclature of Medicine-Clinical Terms (SNOMED CT) terminology. Results: Out of 887,735 patients, 758 were included, of which 328 had axSpA [58.5% male; mean (SD) age of 50.7 (12.7) years], 365 PsA [54.8% female, 53.9 (12.4) years], and 65 non-classified SpA. Mean (SD) time since diagnosis was 36.8 (61.0) and 24.1 (35.2) months for axSpA and PsA, respectively. Only 116 axSpA patients (35.3%) had available Ankylosing Spondylitis Disease Activity Score (ASDAS) or Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at bDMARD onset, of which 61 presented active disease. Disease Activity in PSoriatic Arthritis (DAPSA) or Disease Assessment Score - 28 joints (DAS-28) values at bDMARD onset were available for only 61 PsA (16.7%) patients, with 23 of them having active disease. The number of patients with available tender joint count or swollen joint count assessment was 68 (20.7%) and 59 (18%) for axSpA, and 115 (31.5%) and 119 (32.6%) for PsA, respectively. SEC was used in 63 (19.2%) axSpA patients and in 63 (17.3%) PsA patients. Conclusion: Using NLP, the study showed that around one-third of axSpA and one-sixth of PsA patients have disease activity assessments with ASDAS/BASDAI or DAPSA/DAS-28, respectively, highlighting an area of improvement in these patients’ management.

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Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study

Cited by 13 publications

References 0 publications

Prevalence, T2 Biomarkers, and Cost of Severe Asthma in the Era of Biologics: The BRAVO-1 Study

Prevalence, T2 Biomarkers, and Cost of Severe Asthma in the Era of Biologics: The BRAVO-1 Study

Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses

Using natural language processing to explore characteristics and management of patients with axial spondyloarthritis and psoriatic arthritis treated under real-world conditions in Spain: SpAINET study

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