Asthma Center

Asthma Control in Patients Receiving Advanced Therapies for Severe Asthma With Eosinophilia

Approximately 10% of patients with asthma have severe asthma, defined by the need for high-dose inhaled steroids or oral steroids, either to maintain control or despite which asthma control is still not achieved.¹ In this group, even with optimal therapy, patients experience ongoing symptoms and have higher healthcare utilization. Therapies for severe asthma have significantly advanced in recent years. The Asthma Center uses a personalized approach based on the type of asthma (often referred to as asthma phenotype or endotype). Individuals with or without allergies may have a form of asthma called eosinophilic asthma, which results in significant symptoms and often requires high doses of medications including even oral steroids.

To monitor patients closely for therapeutic response to advanced therapies for severe eosinophilic asthma, such as biologic therapies, Asthma Center providers enroll patients in a registry. The center has > 260 patients enrolled in the registry for various biologics.²⁻⁸

Improvement in ACT Scores for Patients With Severe Eosinophilic Asthma Treated With Biologic Therapyᵃ

2021

ACT = Asthma Control Test

ᵃAlthough treatment options include omalizumab for a large proportion of Asthma Center patients, they were not included in the current analysis.

In the cohort of 260 patients with severe asthma who were treated with anti-IL-5 therapies, the median ACT score significantly improved at follow-up (P < 0.001). Asthma control improved at 1 month and beyond after biologic therapies were initiated.

Percent of Patients Requiring Chronic Oral Steroid Administration While Receiving Biologic Therapyᵃ

2021

ᵃAlthough treatment options include omalizumab for a large proportion of Asthma Center patients, they were not included in the current analysis.

Utilization of oral corticosteroids for treating severe asthma is a source of morbidity from side effects and additional health risks. Asthma Center analysis demonstrates that patients’ need for oral steroids significantly decreased with therapy (P < 0.001).

These outcomes data demonstrate that comprehensive evaluation and multidisciplinary management of patients presenting to the Asthma Center improve asthma control even in the most severe cases. Rigorous monitoring and adjustments of therapies are needed as patients improve or require alternative advanced therapies available.

References

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  2. Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, Humbert M, Katz LE, Keene ON, Yancey SW, Chanez P; MENSA Investigators. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014 Sep 25;371(13):1198-1207.
  3. Bleecker ER, FitzGerald JM, Chanez P, Papi A, Weinstein SF, Barker P, Sproule S, Gilmartin G, Aurivillius M, Werkström V, Goldman M; SIROCCO study investigators. Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial. Lancet. 2016 Oct 29;388(10056):2115-2127.
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  8. Wenzel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, Wang L, Kirkesseli S, Rocklin R, Bock B, Hamilton J, Ming JE, Radin A, Stahl N, Yancopoulos GD, Graham N, Pirozzi G. Dupilumab in persistent asthma with elevated eosinophil levels. N Engl J Med. 2013 Jun 27;368(26):2455-2466.