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Browse ATS 2021 Abstracts

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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.

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Demographic Characteristics and Laboratory Biomarker Testing of Patients Receiving Individual Biologic Therapies for Severe Asthma in the United States

Session Title
TP10 - TP010 CLINICAL AND POPULATION-LEVEL STUDIES OF ASTHMA
Abstract
A1428 - Demographic Characteristics and Laboratory Biomarker Testing of Patients Receiving Individual Biologic Therapies for Severe Asthma in the United States
Author Block: R. A. Panettieri1, W. W. Carr2, B. E. Chipps3, N. L. Lugogo4, W. Soong5, W. C. Moore6, D. Carstens7, F. Trudo7, C. S. Ambrose8; 1Institute for Translational Medicine and Science, Rutgers University, New Brunswick, NJ, United States, 2Allergy & Asthma Associates of Southern California, Mission Viejo, CA, United States, 3Capital Allergy & Respiratory Disease Center, Sacramento, CA, United States, 4Medicine, University of Michigan, Ann Arbor, MI, United States, 5Alabama Allergy & Asthma Center, Birmingham, AL, United States, 6Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest Sch of Med, Winston-Salem, NC, United States, 7BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, United States, 8BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, United States.
Rationale: Despite the growing use of biologics for severe asthma (SA), the real-world characteristics of patients receiving these medications are not well described.
Methods: CHRONICLE is an observational study of specialist-treated US adults (aged ≥18 years) with SA. At enrollment, patients must be: (1) receiving FDA-approved monoclonal antibody therapy for SA; (2) receiving systemic corticosteroids (SCS) or other systemic immunosuppressants for ≥50% of the prior 12 months; or (3) persistently uncontrolled while treated with high-dosage inhaled corticosteroids and additional controllers. We compared baseline characteristics of patients receiving individual biologics at study enrollment from February 2018 to February 2020. Results of laboratory biomarker tests conducted in the 12 months before first biologic initiation were also examined.
Results: Among 1884 enrolled patients, 1219 (65%) patients were receiving biologics at enrollment. Omalizumab was used most commonly (48%), followed by mepolizumab (24%), benralizumab (20%), dupilumab (4%), and reslizumab (3%). Patients treated by hospital-based pulmonologists were less likely to receive omalizumab than patients treated by other specialists (32% vs 51%-55%). Reslizumab recipients were older, more likely to have Medicare coverage, and more likely to be White. Body mass index, employment status, and education level were generally similar across biologics. Receipt of maintenance SCS in the year prior to enrollment was less common among omalizumab recipients (7% vs 15%-20% for mepolizumab, benralizumab, and dupilumab). Of 591 patients with data collected before first biologic initiation, 559 (95%) patients had ≥1 biomarker test result reported. Total IgE level was more frequently reported among patients starting omalizumab (80% vs 46%-51% for other biologics), whereas blood eosinophil count (BEC) was more frequently reported among patients starting other biologics (84%-93% vs 42% for omalizumab) (Table). Fractional exhaled nitric oxide (FeNO) level was reported in 15%-28% of patients. Among patients tested, mepolizumab and benralizumab recipients had higher BECs. Few (3%) omalizumab recipients had total IgE levels <30 vs 18% of mepolizumab and benralizumab recipients and 44% of dupilumab recipients.
Conclusions: Available biologic treatments for SA are being used differently by US specialists across various patient profiles. Biomarker testing was not systematically conducted prior to starting a biologic. Omalizumab recipients had higher total IgE levels, lower BECs, lower FeNO levels, and less commonly received maintenance SCS. Mepolizumab and benralizumab recipients had higher BECs and FeNO levels, whereas dupilumab recipients had lower BECs, total IgE levels, and FeNO levels.