Kosoy Irina, Lew Elisheva, Ledanois Olivier, Derrickson William
Health, Ipsos, New York, NY, USA.
Sanofi, Paris, France.
J Asthma. 2022 May;59(5):1021-1029. doi: 10.1080/02770903.2021.1895208. Epub 2021 Mar 24.
The 2019 GINA guidance incorporates the presence of T2 inflammation in severe asthma patients to determine eligibility for add-on biologic therapy, though little data exists to characterize this population. The objective of this manuscript is to conduct a descriptive analysis to characterize patients with severe asthma in emerging countries based on disease severity, patient exacerbation history, and T2 phenotype.
A cross-sectional survey of physicians treating asthma patients ages 12 years and older was conducted in eight countries. Physicians characterized their severe asthma patients and reported data from their patients' medical charts. Medical chart data was selected from the physicians' six most recent asthma patients taking prescription medication.
A total of 550 physicians completed the survey and filled out 3,300 patient record forms. A total of 876 patients have been characterized with uncontrolled severe asthma. Of the 420 patients with available EOS lab data, 40% are indicated with T2 inflammation (EOS ≥150/µL). Ninety-one percent of all patients with available IgE lab data ( = 498) had IgE 30 - 1500 IU/mL indicating allergy-driven asthma. Finally, chronic OCS use (as reported by physicians) was reported in 11% of patients.
This research revealed that 65% of patients had at least one of three T2 inflammation comorbidities assessed: allergic rhinitis, chronic rhinosinusitis with nasal polyps, and atopic dermatitis. Discrepancies were observed between patients' treatment regimens and GINA step reported, suggesting there may be room to improve understanding of asthma severity as defined per GINA guidelines as well as asthma control assessment in clinical practice.
2019年全球哮喘防治创议(GINA)指南纳入了重度哮喘患者中T2炎症的存在情况,以确定是否适合加用生物制剂治疗,不过目前几乎没有数据来描述这一人群的特征。本论文的目的是进行描述性分析,以根据疾病严重程度、患者加重病史和T2表型来描述新兴国家重度哮喘患者的特征。
在8个国家对治疗12岁及以上哮喘患者的医生进行了横断面调查。医生对其重度哮喘患者进行了特征描述,并报告了患者病历中的数据。病历数据选自医生最近诊治的6例正在服用处方药的哮喘患者。
共有550名医生完成了调查并填写了3300份患者记录表。共有876例患者被诊断为未控制的重度哮喘。在420例有可用嗜酸性粒细胞(EOS)实验室数据的患者中,40%显示存在T2炎症(EOS≥150/μL)。在所有有可用免疫球蛋白E(IgE)实验室数据的患者(n = 498)中,91%的患者IgE为30 - 1500 IU/mL,表明为过敏驱动型哮喘。最后,医生报告11%的患者长期使用口服糖皮质激素(OCS)。
本研究表明,65%的患者至少有以下三种评估的T2炎症合并症之一:过敏性鼻炎、伴有鼻息肉的慢性鼻 - 鼻窦炎和特应性皮炎。观察到患者的治疗方案与报告的GINA分级之间存在差异,这表明在理解GINA指南定义的哮喘严重程度以及临床实践中的哮喘控制评估方面可能仍有改进空间。