ArticleJournal of asthma and allergy2022
Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy.
Article in Journal of asthma and allergy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Can we predict who will benefit most from biologics in severe asthma? A post-hoc analysis of two phase 3 trials.Respiratory research · 2023Trial
- Understanding disease burden, challenges in current treatment strategies and call for action for management of severe asthma in Asia: a position statement from Asian respiratory experts.Frontiers in allergy · 2026Review
- Fixed airway obstruction and bronchodilator responsiveness phenotypes in severe asthma population from SANI registry.BMJ open respiratory research · 2025Article
- Review
- Non-T2 asthma.Current opinion in pulmonary medicine · 2025Review
- International Severe Asthma Registry (ISAR): 2017-2024 Status and Progress Update.Tuberculosis and respiratory diseases · 2025Article
- Burden of Type 2 and Oral Corticosteroids Related Comorbidities in Severe Asthma Patients from the Gulf Countries: A Comparative Study from The ISAR Registry.Journal of asthma and allergy · 2025Article
- Real-World Biologic Use Patterns in Severe Asthma, 2015-2021: The CLEAR Study.Pragmatic and observational research · 2025Article
- Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme.The European respiratory journal · 2024Observational
- Big Data Research on Severe Asthma.Tuberculosis and respiratory diseases · 2024Article
- Real-World Effectiveness of Biologics in Patients With Severe Asthma: Analysis of the KoSAR.Allergy, asthma & immunology research · 2024Article
- Severe asthma care trajectories: the French RAMSES cohort.ERJ open research · 2024Article
- Difficult-To-Treat and Severe Asthma: Can Real-World Studies On Effectiveness of Biological Treatments Change the Lives of Patients?Pragmatic and observational research · 2024Review
- Disease Burden and Access to Biologic Therapy in Patients with Severe Asthma, 2017-2022: An Analysis of the International Severe Asthma Registry.Journal of asthma and allergy · 2024Article
- [Consensus document for Severe Asthma. 2025 Update].Open respiratory archivesArticle
Corrections and comments
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Authors and funding
64 authors at 20 institutions in 28 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Many severe asthma patients with high oral corticosteroid exposure (HOCS) often do not initiate biologics despite being eligible. This study aimed to compare the characteristics of severe asthma patients with HOCS who did and did not initiate biologics. Methods: Baseline characteristics of patients with HOCS (long-term maintenance OCS therapy for at least 1 year, or ≥4 courses of steroid bursts in a year) from the International Severe Asthma Registry (ISAR; https://isaregistries.org/), who initiated or did not initiate biologics (anti-lgE, anti-IL5/5R or anti-IL4R), were described at the time of biologic initiation or registry enrolment. Statistical relationships were tested using Pearson's chi-squared tests for categorical variables, and t-tests for continuous variables, adjusting for potential errors in multiple comparisons. Results: Between January 2015 and February 2021, we identified 1412 adult patients with severe asthma from 19 countries that met our inclusion criteria of HOCS, of whom 996 (70.5%) initiated a biologic and 416 (29.5%) did not. The frequency of biologic initiation varied across geographical regions. Those who initiated a biologic were more likely to have higher blood eosinophil count (483 vs 399 cells/µL, p=0.003), serious infections (49.0% vs 13.3%, p<0.001), nasal polyps (35.2% vs 23.6%, p<0.001), airflow limitation (56.8% vs 51.8%, p=0.013), and uncontrolled asthma (80.8% vs 73.2%, p=0.004) despite greater conventional treatment adherence than those who did not start a biologic. Both groups had similar annual asthma exacerbation rates in the previous 12 months (5.7 vs 5.3, p=0.147). Conclusion: Around one third of severe HOCS asthma patients did not receive biologics despite a similar high burden of asthma exacerbations as those who initiated a biologic therapy. Other disease characteristics such as eosinophilic phenotype, serious infectious events, nasal polyps, airflow limitation and lack of asthma control appear to dictate biologic use.
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