Biologic Treatment Patterns and Phenotyping in Severe Uncontrolled Asthma: A Multinational Study
Author(s)
Christine Mai, Dr (MD1, Andrei Horia SEFERIAN, Dr (MD)2, Stéphane DENIAU, MSc,Eng.3, Manuel GUZMAN MARTIN, Msc.4, Bertrand De Buhren, Dr (Ph)4, Justin FRANCOIS, Msc.4, Stéphanie PETIT, Msc.4, Aysheh ALI, Msc.4.
1AplusA Real World, Lyon, France, 2Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin-Bicêtre,, Paris, France, 3RWE BU Director - AplusA Real World, A+A SAS, Lyon, France, 4AplusA, Lyon, France.
1AplusA Real World, Lyon, France, 2Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin-Bicêtre,, Paris, France, 3RWE BU Director - AplusA Real World, A+A SAS, Lyon, France, 4AplusA, Lyon, France.
OBJECTIVES: The management of severe uncontrolled asthma (SUA) has been a primary focus for healthcare providers over the past 15 years. While monoclonal antibodies that target IgE or type-2 cytokines and their receptors have shown efficacy, they are not suitable for non-allergic and non-eosinophilic asthma. For these individuals, the recent introduction of tezepelumab - an antibody that targets thymic stromal lymphopoietin (TSLP) marks the first biologic therapy available for this phenotype.
METHODS: This multinational study (December 2024-February 2025) analyzed anonymous charts of 1856 SUA patients from biologics prescribers (pulmonologists or other specialists) across EU5 (France, Germany, Italy, Spain, UK), Japan and Canada. Clinical and biological data focused on biologic management of SUA.
RESULTS: Of the 1856 patients, 45% were male and 55% were female with a median age of 48 years. Type 2 inflammation was present in 91% of cases. Comorbidities included moderate to severe nasal polyposis in one-third of patients, obesity in 14%, atopic dermatitis or food allergy in 27%, fixed airway obstruction or COPD in 17%; 25% had no comorbidities. Most of the patients were on triple inhaled therapy (ICS-LABA-LAMA) and 9% required long-term oral corticosteroids before starting their biologic therapy (7% alongside it).Biologics distribution was as follows: Dupilumab (29%), Mepolizumab (21%), Benralizumab (19%), Omalizumab (9%) and Tezepelumab (22%). Treatment selection was based on asthma phenotype in 51% of cases and aimed at reducing exacerbations, hospitalizations or emergency department visits. Biologics were typically used for an average of 23.2 months before switching with lack of efficacy being the reason in 44% of cases.
CONCLUSIONS: Even with the introduction of tezepelumab and its broad indications, precise asthma phenotyping remains essential to guide the selection of the most appropriate biologic therapy for patients with SUA.
METHODS: This multinational study (December 2024-February 2025) analyzed anonymous charts of 1856 SUA patients from biologics prescribers (pulmonologists or other specialists) across EU5 (France, Germany, Italy, Spain, UK), Japan and Canada. Clinical and biological data focused on biologic management of SUA.
RESULTS: Of the 1856 patients, 45% were male and 55% were female with a median age of 48 years. Type 2 inflammation was present in 91% of cases. Comorbidities included moderate to severe nasal polyposis in one-third of patients, obesity in 14%, atopic dermatitis or food allergy in 27%, fixed airway obstruction or COPD in 17%; 25% had no comorbidities. Most of the patients were on triple inhaled therapy (ICS-LABA-LAMA) and 9% required long-term oral corticosteroids before starting their biologic therapy (7% alongside it).Biologics distribution was as follows: Dupilumab (29%), Mepolizumab (21%), Benralizumab (19%), Omalizumab (9%) and Tezepelumab (22%). Treatment selection was based on asthma phenotype in 51% of cases and aimed at reducing exacerbations, hospitalizations or emergency department visits. Biologics were typically used for an average of 23.2 months before switching with lack of efficacy being the reason in 44% of cases.
CONCLUSIONS: Even with the introduction of tezepelumab and its broad indications, precise asthma phenotyping remains essential to guide the selection of the most appropriate biologic therapy for patients with SUA.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD14
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)