GlaxoSmithKline, Research Triangle Park, NC, USA.
Adelphi Real World, Bollington, UK.
J Asthma. 2022 Sep;59(9):1839-1849. doi: 10.1080/02770903.2021.1971700. Epub 2021 Sep 6.
To assess patient- and physician-reported reasons for discontinuing biologic therapy among patients with severe asthma from a real-world US cohort.
This retrospective analysis surveyed US physicians and their patients with severe asthma who were receiving/had previously received biologic therapy between August and December 2019. Physicians managing ≥3 patients with asthma per month completed surveys on disease management, demographics, exacerbation history, and biologic adherence for eligible patients. Patients could voluntarily complete a questionnaire, providing perceptions of their disease and treatment.
117 physicians completed case reports for 285 patients; 85 patients had discontinued biologic therapy. Physicians ( = 85) and patients ( = 64) reported patient request (28.2% and 46.9%), shortness of breath (45.9% and 23.4%), other chronic respiratory symptoms (29.4% and 10.9%), cost/reimbursement (17.7%/9.4% and 20.3%/7.8%), and exacerbations (25.9% and 10.9%) among the main reasons for biologic discontinuation. Patients who continued biologic therapy were older (mean age 47.6 years) than those who discontinued (43.8 years), and were more likely to have ≥2 exacerbations in the previous year (52.5% vs 35.3%), allergic rhinitis (70.0% vs 62.4%), or chronic rhinosinusitis (30.0% vs 12.9%). Side effects were cited as reasons by only 15.3% and 7.8% of physicians and patients, respectively.
The most common reasons given for discontinuation of biologic therapy were lack of symptom control, exacerbations, cost, and patient request. These data highlight the complexity of care for this patient group and the need for ongoing, regular assessment of common challenges to biologic continuation and reasons for discontinuation, including both clinical and non-clinical factors.
评估来自美国真实世界队列的重度哮喘患者停止使用生物制剂治疗的患者和医生报告的原因。
这项回顾性分析调查了美国医生及其 2019 年 8 月至 12 月期间正在接受/之前曾接受过生物制剂治疗的重度哮喘患者。每月管理≥3 名哮喘患者的医生为符合条件的患者完成了关于疾病管理、人口统计学、加重史和生物制剂依从性的调查。患者可以自愿填写问卷，提供对其疾病和治疗的看法。
117 名医生为 285 名患者完成了病例报告；85 名患者已停止使用生物制剂。医生（85 人）和患者（64 人）报告的主要停药原因包括患者要求（28.2%和 46.9%）、呼吸急促（45.9%和 23.4%）、其他慢性呼吸道症状（29.4%和 10.9%）、费用/报销（17.7%/9.4%和 20.3%/7.8%）和加重（25.9%和 10.9%）。继续使用生物制剂的患者年龄较大（平均年龄 47.6 岁），而停止使用的患者年龄较小（43.8 岁），且过去一年中更有可能出现≥2 次加重（52.5%比 35.3%）、过敏性鼻炎（70.0%比 62.4%）或慢性鼻-鼻窦炎（30.0%比 12.9%）。只有 15.3%的医生和 7.8%的患者将副作用作为停药原因。
停止生物制剂治疗的最常见原因是缺乏症状控制、加重、费用和患者要求。这些数据突出了该患者群体护理的复杂性，需要持续定期评估生物制剂继续治疗和停药的常见挑战及原因，包括临床和非临床因素。
