“Real-life” management of patients with severe asthma in the biologics era: Can we do better?

Jérémy Charriot (1, 2) , Milka Maravic (3, 4) , Michael Huguet (4) , Isabelle Vachier (2) , Carey Suehs (2) , Arnaud Bourdin (1, 2)

1 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 Hôpital Lariboisière-Fernand-Widal [APHP]
4 IQVIA

Background: Discrepancies exist between guidelines and real-life practice in severe asthma. Objectives: To establish profiles for severe asthma patients according to their maintenance therapies and identify unmet needs.Methods: 2432 French lung specialists and allergists were invited to participate in a severe asthma survey between March and April 2018. Retrospective data were collected using an electronic case report form developed by IQVIA.Results: 71 respiratory physicians and/or allergists participated in the study, providing data for 736 severe asthma patients. The annual mean rates of hospitalization and exacerbation in the previous year were 0.65 (SD = 0.5) and 2.25 (SD = 1.0), respectively. One hundred one (13.7%) patients were treated with oral steroids; the mean dosage regimen was 16.1 mg per day (SD = 11.2). ICS-LABA-LAMA triple inhaled therapy was reported for 288 patients (39%); 231 patients (31.4%) had one biologic in their maintenance treatment. Among patients hospitalized at least once in the previous year (n = 311), 89 (28.5%) were currently treated with biologics, and 61 (19.6%) with oral steroids. One hundred sixty-six patients with uncontrolled asthma and no current biologic therapy had data for "T2 status"; 78 (47%), 89 (53.6%) and 137 (82.5%) of them had treatment criteria respectively for an anti-IgE, anti-IL5-pathway or anti-IL-4/IL-13 pathway therapy; 22 (13.2%) were ineligible for any current biologic according to biomarkers.Conclusion: Our study updated "real-life" therapeutic management data for severe asthma in France in 2018. We highlighted a need for improved patient-phenotyping. This work also gives a striking insight of the position of current and forthcoming biologics.

Mots clés: Asthma; Biologic therapy; Biomakers; Phenotype

Domaines: Allergologie; Pneumologie et système respiratoire

Jérémy Charriot, Milka Maravic, Michael Huguet, Isabelle Vachier, Carey Suehs, et al.. “Real-life” management of patients with severe asthma in the biologics era: Can we do better?. World Allergy Organization Journal, 2021, 14 (4), pp.100528. ⟨10.1016/j.waojou.2021.100528⟩. ⟨hal-03179753v2⟩