Impact of biologic initiation on oral corticosteroids in the International Severe Asthma Registry and the Optimum Patient Care Research Database: a pooled analysis

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This study estimated the impact of biologic initiation on using oral corticosteroids (OCS) in severe asthma (SA) patients from real-life specialist and primary care settings. Adult patients with SA were identified from the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, UK). Biologic initiators were identified and propensity-score matched with non-initiators. Impact of biologic initiation on total OCS (TOCS, including bursts for exacerbations) daily dose in the 1st- and 2nd-year follow-up period was assessed using multivariable generalized linear models. Among 8060 patients (ISAR 34%, OPCRD 76%), the risk ratios (RR) of biologic initiators achieving zero TOCS in year 1 and 2 of follow up were 1.53 (95% CI: 1.28-1.82) and 1.72 (1.43-2.07), while the RRs of achieving low daily dose (0-5 mg) were 1.07 (1.00-1.16) and 1.11 (1.03-1.19), respectively. Biologic initiators also had a greater likelihood of achieving any reduction in TOCS and optimal (≥75%) reduction in both year 1 and 2 of follow-up (Table 1). Compared to non-initiators, biologic initiators had greater reduction in TOCS daily dose in both 1st (mg/day, -3.2 vs -2.0) and 2nd (−4.2 vs -3.5) year (p<.001). Biologic initiation results in reduced OCS burden in patients with SA over two years versus usual care. erj;64/suppl_68/PA2175/F1 F1 F1

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