Burden of severe asthma by biologic use and eligibility: an analysis of the International Severe Asthma Registry

Background: Patients with severe asthma have differing clinical manifestations. There is limited evidence on burden of disease in patients who are eligible and ineligible for biologic therapy. Objective: To describe clinical characteristics of patients with severe asthma grouped by biologic eligibility. Methods: This study included patients from 22 countries enrolled in the International Severe Asthma Registry from May 2017 to October 2021. Patients were grouped by biologic eligibility, biologic use or uncontrolled asthma (defined in Table). Clinical characteristics were described in the 12 months before the visit when eligibility criteria were defined. Results: Of 10 754 patients, 6328 (58.8%) were biologic eligible. Among patients who were eligible, biologic users, biologic users with uncontrolled asthma or biologic ineligible, annualized exacerbation rates were 2.74, 2.84, 2.84 and 1.44, respectively; annualized hospitalization rates were 0.44, 0.42, 0.44 and 0.28, respectively; annualized emergency department visit rates were 1.06, 1.08, 0.91 and 0.49, respectively; and 11.2%, 12.7%, 19.0% and 1.9% had long-term oral corticosteroid use, respectively (Table). Conclusion: Patients with severe asthma experienced substantial disease burden and unmet need, including biologic users or those who were biologic eligible or ineligible. Proper management and additional therapy options are needed for this population.