Ding Bo, Chen Stephanie, Srivastava Divyansh, Quinton Anna, Cook William, Papi Alberto, Reddel Helen K
BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden.
BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
J Asthma Allergy. 2023 Jun 11;16:611-624. doi: 10.2147/JAA.S401445. eCollection 2023.
Few studies have quantified symptom burden, health status, and productivity in patients with uncontrolled and controlled severe asthma. Up-to-date, real-world, global evidence is needed.
To quantify symptom burden, health status, and productivity in patients with uncontrolled and controlled severe asthma using baseline data from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329).
NOVELTY included patients aged ≥18 years (or ≥12 years in some countries) from primary care and specialist centres in 19 countries, with a physician-assigned diagnosis of asthma, asthma+chronic obstructive pulmonary disease (COPD), or COPD. Disease severity was physician-assessed. Uncontrolled severe asthma was defined by an Asthma Control Test (ACT) score <20 and/or severe physician-reported exacerbations in the previous year; controlled severe asthma required an ACT score ≥20 and no severe exacerbations. Assessment of symptom burden included Respiratory Symptoms Questionnaire (RSQ) and ACT score. Assessment of health status included St George's Respiratory Questionnaire (SGRQ), EuroQoL 5 Dimensions 5 Levels Health Questionnaire (EQ-5D-5L) index value, and EQ-5D-5L Visual Analog Score (EQ-VAS). Assessment of productivity loss included absenteeism, presenteeism, overall work impairment, and activity impairment.
Of 1652 patients with severe asthma, asthma was uncontrolled in 1078 (65.3%; mean age 52.6 years, 65.8% female) and controlled in 315 (19.1%; mean age 55.2 years, 56.5% female). With uncontrolled versus controlled severe asthma, symptom burden was higher (mean RSQ score 7.7 vs 2.5), health status more impaired (mean SGRQ total score 47.5 vs 22.4; mean EQ-5D-5L index value 0.68 vs 0.90; mean EQ-VAS score 64.1 vs 78.1), and productivity lower (presenteeism 29.3% vs 10.5%).
Our findings highlight the symptom burden of uncontrolled severe asthma compared with controlled severe asthma and its impact on patient health status and productivity, and support the need for interventions to improve control of severe asthma.
很少有研究对未控制和已控制的重度哮喘患者的症状负担、健康状况和生产力进行量化。需要最新的、真实世界的全球证据。
利用新型观察性纵向研究(NOVELTY;NCT02760329)的基线数据,对未控制和已控制的重度哮喘患者的症状负担、健康状况和生产力进行量化。
NOVELTY纳入了来自19个国家初级保健和专科中心的年龄≥18岁(在某些国家为≥12岁)的患者,这些患者经医生诊断患有哮喘、哮喘+慢性阻塞性肺疾病(COPD)或COPD。疾病严重程度由医生评估。未控制的重度哮喘定义为哮喘控制测试(ACT)评分<20分和/或前一年医生报告的严重加重;已控制的重度哮喘要求ACT评分≥20分且无严重加重。症状负担评估包括呼吸症状问卷(RSQ)和ACT评分。健康状况评估包括圣乔治呼吸问卷(SGRQ)、欧洲五维健康量表5级健康问卷(EQ-5D-5L)指数值和EQ-5D-5L视觉模拟评分(EQ-VAS)。生产力损失评估包括旷工、出勤主义、总体工作受损和活动受损。
在1652例重度哮喘患者中,1078例(65.3%;平均年龄52.6岁,女性占65.8%)哮喘未得到控制,315例(19.1%;平均年龄55.2岁,女性占56.5%)哮喘得到控制。与已控制的重度哮喘相比,未控制的重度哮喘症状负担更高(平均RSQ评分为7.7分对2.5分),健康状况受损更严重(平均SGRQ总分47.5分对22.4分;平均EQ-5D-5L指数值0.68对0.90;平均EQ-VAS评分为64.1分对78.1分),生产力更低(出勤主义为29.