ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
Search Tips:
- Use the keyword search to search by keyword or author's name.
- Filter your search results by selecting the checkboxes that apply.
- Click on "Clear" to clear the form and start a new search. .
Search results will display below the form.
Worldwide Characterization of Severe Asthma Patients Eligible for Both Anti-IL5 and Anti-IgE: Data from the International Severe Asthma Registry (ISAR)
Session Title
TP15 - TP015 UPDATES IN ADHERENCE AND TREATMENT OF LUNG DISEASE
Abstract
A1614 - Worldwide Characterization of Severe Asthma Patients Eligible for Both Anti-IL5 and Anti-IgE: Data from the International Severe Asthma Registry (ISAR)
Author Block: M. Sadatsafavi1, R. Murray2, N. Ali2, T. Trung3, D. Price4, ISAR FIRE Working Group; 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada, 2Observational and Pragmatic Research Institute, Singapore, Singapore, 3AstraZeneca, Gaithersburg, MD, United States, 4Observational and Pragmatic Research Institute, Singapore, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Rationale: Approximately one-third of severe asthma patients are eligible for both anti-IgE and anti-IL-5/5R therapy. However, it is not clear whether one class of biologic works better than the other amongst patients eligible for both. Our aim was to describe the demographic and clinical characteristics of anti-IgE or anti-IL-5/5R users who were eligible for both, and subsequently started either modality, using data from the International Severe Asthma Registry (ISAR; http;//isaregistries.org/). ISAR includes patients aged ≥18 years old at GINA Step 5 treatment, or with uncontrolled asthma at GINA Step 4. Methods: Patients eligible for both anti-IgE and anti-IL-5/5R, who subsequently started either modality from 19 ISAR participating countries, recruited between January 2015 and September 2020, were included. They must have had ≥1 year of data prior to the biologic initiation date for study inclusion. Eligibility for both biologics was ascertained universally across all countries using frequent biologic-specific criteria: elevated blood eosinophil count, serum IgE, allergic-mediated asthma, and history of exacerbations at baseline. Pre-biologic-initiation demographic and clinical variables were described for both anti-IgE and anti-IL-5/5R groups using data from 2015 onwards, when both therapies were available. Groups were compared using Pearson’s chi-square tests and t-tests. Results: Amongst 8826 patients, 1868 (21.2%) were considered eligible for both anti-IgE and anti-IL-5/5R. Of these, 659 started anti-IgE and 570 started anti-IL-5/5R after 2015, comprising the study cohort. 33.2% of anti-IgE and 45.7% of anti-IL-5/5R patients were also on long-term oral corticosteroids (LT-OCS) at the time of biologic initiation. Although differences were small, anti-IL-5/5R patients were slightly older, had later asthma onset, and were more likely to have uncontrolled asthma, ≥2 exacerbations, and FeNO >50 ppb (Table). Patients who received anti-IgE were more likely to be female, had a slightly higher mean BMI, and a higher prevalence of osteoporosis. These demographic, clinical, and co-morbidity patterns were similar irrespective of LT-OCS use, with the exception of osteoporosis prevalence, which was more elevated in the anti-IgE group versus anti-IL-5/5R for those on LT-OCS (45.0% [n=68/151] versus 15.2% [n=27/178]). Conclusion: Approximately one-fifth of severe asthma patients in ISAR were eligible for both anti-IgE and anti-IL-5/5R therapy. Most of these patients initiated biologic treatment. Anti-IL-5/5R eligible patients tended to have more severe disease pre-biologic initiation than their anti-IgE counterparts, which has implications when comparing effectiveness of these biologics. Funding: ISAR is conducted by OPC Global, and co-funded by OPC Global and AstraZeneca.
Author Block: M. Sadatsafavi1, R. Murray2, N. Ali2, T. Trung3, D. Price4, ISAR FIRE Working Group; 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada, 2Observational and Pragmatic Research Institute, Singapore, Singapore, 3AstraZeneca, Gaithersburg, MD, United States, 4Observational and Pragmatic Research Institute, Singapore, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Rationale: Approximately one-third of severe asthma patients are eligible for both anti-IgE and anti-IL-5/5R therapy. However, it is not clear whether one class of biologic works better than the other amongst patients eligible for both. Our aim was to describe the demographic and clinical characteristics of anti-IgE or anti-IL-5/5R users who were eligible for both, and subsequently started either modality, using data from the International Severe Asthma Registry (ISAR; http;//isaregistries.org/). ISAR includes patients aged ≥18 years old at GINA Step 5 treatment, or with uncontrolled asthma at GINA Step 4. Methods: Patients eligible for both anti-IgE and anti-IL-5/5R, who subsequently started either modality from 19 ISAR participating countries, recruited between January 2015 and September 2020, were included. They must have had ≥1 year of data prior to the biologic initiation date for study inclusion. Eligibility for both biologics was ascertained universally across all countries using frequent biologic-specific criteria: elevated blood eosinophil count, serum IgE, allergic-mediated asthma, and history of exacerbations at baseline. Pre-biologic-initiation demographic and clinical variables were described for both anti-IgE and anti-IL-5/5R groups using data from 2015 onwards, when both therapies were available. Groups were compared using Pearson’s chi-square tests and t-tests. Results: Amongst 8826 patients, 1868 (21.2%) were considered eligible for both anti-IgE and anti-IL-5/5R. Of these, 659 started anti-IgE and 570 started anti-IL-5/5R after 2015, comprising the study cohort. 33.2% of anti-IgE and 45.7% of anti-IL-5/5R patients were also on long-term oral corticosteroids (LT-OCS) at the time of biologic initiation. Although differences were small, anti-IL-5/5R patients were slightly older, had later asthma onset, and were more likely to have uncontrolled asthma, ≥2 exacerbations, and FeNO >50 ppb (Table). Patients who received anti-IgE were more likely to be female, had a slightly higher mean BMI, and a higher prevalence of osteoporosis. These demographic, clinical, and co-morbidity patterns were similar irrespective of LT-OCS use, with the exception of osteoporosis prevalence, which was more elevated in the anti-IgE group versus anti-IL-5/5R for those on LT-OCS (45.0% [n=68/151] versus 15.2% [n=27/178]). Conclusion: Approximately one-fifth of severe asthma patients in ISAR were eligible for both anti-IgE and anti-IL-5/5R therapy. Most of these patients initiated biologic treatment. Anti-IL-5/5R eligible patients tended to have more severe disease pre-biologic initiation than their anti-IgE counterparts, which has implications when comparing effectiveness of these biologics. Funding: ISAR is conducted by OPC Global, and co-funded by OPC Global and AstraZeneca.
