Mathur Sameer, Corbridge Thomas, Packnett Elizabeth, Jariwala-Parikh Krutika, Deb Arijita
University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Medical Affairs, GSK, Durham, NC, USA.
Allergy Asthma Clin Immunol. 2024 Oct 24;20(1):56. doi: 10.1186/s13223-024-00917-4.
Patients with asthma with an eosinophilic phenotype may be eligible for additional treatment options to improve disease control; however, the prevalence and frequency of eosinophil testing is unknown. This study assessed blood eosinophil count testing prevalence in patients with asthma by exacerbation frequency and healthcare provider (HCP) type.
This was a retrospective, longitudinal, real-world study (GSK ID: 214470) utilizing the Merative Explorys Universe electronic health records database. Eligible patients had ≥ 2 asthma diagnostic codes (January 2016-December 2018) (Index date: first asthma diagnosis). Outcomes included patient demographics and clinical characteristics (12 months pre-index [baseline]), and prevalence of blood eosinophil count testing, stratified by exacerbation frequency (infrequent exacerbations [< 2]) or frequent exacerbations [≥ 2] or primary HCP (Allergist/Pulmonologist, a primary care physician [PCP] or other HCP) during the 12 months post-index (follow-up).
Of 400,254 patients included (mean age: 51.2 years; 70.8% female), the most common provider type at baseline was a PCP (76.8%). A higher proportion of patients with frequent exacerbations had blood eosinophil count tests at baseline (55.4-69.5%) and follow-up (67.9-75.1%), compared with patients with infrequent exacerbations (55.5-63.7%, 62.4-67.3%). Significantly more patients in the Allergist/Pulmonologist subgroup had ≥ 1 blood eosinophil count test result compared with patients in the PCP subgroup at both baseline (59.9% vs. 50.7%; p < 0.001) and follow-up (59.0% vs. 56.2%; p < 0.001). In the total population, the mean (SD) number of tests ordered was 3.4 (5.3) and 4.1 (6.4) during the baseline and follow-up periods, respectively. A greater mean number of tests were ordered for patients with frequent exacerbations, most apparently in the Allergist/Pulmonologist subgroup during baseline and follow-up (7.4 vs. 4.9). For patients with frequent exacerbations and blood eosinophil count test results, the mean (SD) number of tests ranged from 3.1 (4.6) to 5.8 (8.3) at baseline and 5.1 (8.5) to 7.4 (10.6) during follow-up.
The prevalence of blood eosinophil count testing in patients with asthma remains suboptimal. Routine blood eosinophil count testing should be considered by HCPs for patients with asthma to increase identification of the eosinophilic asthma phenotype, which may inform the decision to advance to targeted biologic therapy.
具有嗜酸性粒细胞表型的哮喘患者可能有资格获得更多改善疾病控制的治疗选择；然而，嗜酸性粒细胞检测的患病率和频率尚不清楚。本研究通过加重频率和医疗服务提供者（HCP）类型评估哮喘患者的血液嗜酸性粒细胞计数检测患病率。
这是一项回顾性、纵向、真实世界研究（GSK ID：214470），利用默克多探索者宇宙电子健康记录数据库。符合条件的患者有≥2个哮喘诊断代码（2016年1月至2018年12月）（索引日期：首次哮喘诊断）。结果包括患者人口统计学和临床特征（索引前12个月[基线]），以及血液嗜酸性粒细胞计数检测的患病率，按索引后12个月（随访）期间的加重频率（不频繁加重[<2次]或频繁加重[≥2次]）或主要HCP（过敏症专科医生/肺病专家、初级保健医生[PCP]或其他HCP）分层。
纳入的400254例患者（平均年龄：51.2岁；70.8%为女性）中，基线时最常见的医疗服务提供者类型是PCP（76.8%）。与不频繁加重的患者（55.5 - 63.7%，62.4 - 67.3%）相比，频繁加重的患者在基线（55.4 - 69.5%）和随访（67.9 - 75.1%）时有更高比例的血液嗜酸性粒细胞计数检测。在基线（59.9%对50.7%；p<0.001）和随访（59.0%对56.2%；p<0.001）时，过敏症专科医生/肺病专家亚组中≥1次血液嗜酸性粒细胞计数检测结果的患者明显多于PCP亚组中的患者。在总体人群中，基线期和随访期的平均（标准差）检测次数分别为3.4（5.3）和4.1（6.4）。频繁加重的患者检测次数更多，最明显的是在基线和随访期间的过敏症专科医生/肺病专家亚组（7.4对4.9）。对于频繁加重且有血液嗜酸性粒细胞计数检测结果的患者，基线时的平均（标准差）检测次数为3.1（4.6）至5.8（8.3），随访期间为5.1（8.5）至7.4（
