Soong Weily, Chipps Bradley E, Carr Warner, Trevor Jennifer, Patel Arpan, Clarke Nicole, Carstens Donna D, Ambrose Christopher S
AllerVie Health, AllerVie Clinical Research, Birmingham, AL, USA.
Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA.
J Asthma Allergy. 2024 May 10;17:441-448. doi: 10.2147/JAA.S452386. eCollection 2024.
Patients living with severe asthma (SA) experience multiple health-related quality of life (HRQoL) impairments. This study examined HRQoL changes after biologic treatment initiation among a large, real-world cohort of patients with SA.
CHRONICLE is an ongoing observational study of subspecialist-treated adults with SA who receive biologics or maintenance systemic corticosteroids or are uncontrolled on high-dosage inhaled corticosteroids with additional controllers. Patients enrolled February 2018-February 2023 were asked to complete the St. George's Respiratory Questionnaire (SGRQ) every 6 months (total score range of 0-100 [0=best possible health], meaningful change threshold is a 4-unit reduction in the total score). Changes in SGRQ responses from 6 months before initiation to 12 to 18 months after initiation were summarized.
A total of 76 patients completed the SGRQ 0 to 6 months before and 12 to 18 months after biologic initiation. The mean (SD) SGRQ total score decreased from 52.2 (20.6) to 41.9 (23.8), with improvement across the symptoms (-14.5), activity (-11.0), and impacts (-8.3) components. For specific impairments reported by ≥50% of patients before biologic initiation, fewer reported each impairment after biologic initiation; the largest reductions were for "Questions about what activities usually make you feel short of breath these days [Walking outside on level ground]" (67% to 43%), "Questions about other effects that your respiratory problems may have on you these days [I feel that I am not in control of my respiratory problems]" (55% to 34%), and "Questions about your cough and shortness of breath these days [My coughing or breathing disturbs my sleep]" (63% to 45%).
In this real-world cohort of adults with SA, biologic initiation was associated with meaningful improvements in asthma-related HRQoL. These data provide further insight into the burden SA places on patients and the benefits of biologic treatment.
重度哮喘（SA）患者存在多种与健康相关的生活质量（HRQoL）损害。本研究在一个大型的、真实世界的SA患者队列中，考察了生物制剂治疗开始后HRQoL的变化。
CHRONICLE是一项正在进行的观察性研究，研究对象为接受专科治疗的成年SA患者，这些患者接受生物制剂或维持性全身糖皮质激素治疗，或在高剂量吸入糖皮质激素联合其他控制药物治疗下仍未得到控制。纳入2018年2月至2023年2月的患者被要求每6个月完成一次圣乔治呼吸问卷（SGRQ）（总分范围为0至100分[0 = 最佳健康状态]，有意义的变化阈值是总分降低4分）。总结了从开始治疗前6个月到开始治疗后12至18个月SGRQ回答的变化。
共有76名患者在生物制剂开始治疗前0至6个月以及开始治疗后12至18个月完成了SGRQ。SGRQ总分均值（标准差）从52.2（20.6）降至41.9（23.8），症状（-14.5）、活动（-11.0）和影响（-8.3）三个分量表均有改善。对于生物制剂开始治疗前≥50%的患者报告的特定损害，生物制剂开始治疗后报告每种损害的患者减少；减少幅度最大的是 “关于这些天哪些活动通常会让你感到气短的问题[在平地上外出散步]”（从67%降至43%）、“关于这些天你的呼吸问题可能对你产生的其他影响的问题[我觉得我无法控制我的呼吸问题]”（从55%降至34%）以及“关于这些天你的咳嗽和气短的问题[我的咳嗽或呼吸干扰我的睡眠]”（从63%降至45%）。
在这个真实世界的成年SA患者队列中，开始使用生物制剂与哮喘相关的HRQoL有意义的改善相关。这些数据进一步揭示了SA给患者带来的负担以及生物制剂治疗的益处。
