Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)

Wang Eileen; Michael E Wechsler; Trung N Tran; Liam G Heaney; Rupert C Jones; Andrew N Menzies-Gow; John Busby; David J Jackson; Paul E Pfeffer; Chin Kook Rhee; You Sook Cho; G Walter Canonica; Enrico Heffler; Peter G Gibson; Mark Hew; Matthew Peters; Erin S Harvey; Mariana Alacqua; James Zangrilli; Lakmini Bulathsinhala; Victoria A Carter; Isha Chaudhry; Neva Eleangovan; Naeimeh Hosseini; Ruth B Murray; David B Price

doi:10.1016/j.chest.2019.10.053

Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)

Wang Eileen, Michael E Wechsler, Trung N Tran, Liam G Heaney, Rupert C Jones, Andrew N Menzies-Gow, John Busby, David J Jackson, Paul E Pfeffer, Chin Kook Rhee, You Sook Cho, G Walter Canonica, Enrico Heffler, Peter G Gibson, Mark Hew, Matthew Peters, Erin S Harvey, Mariana Alacqua, James Zangrilli, Lakmini BulathsinhalaVictoria A Carter, Isha Chaudhry, Neva Eleangovan, Naeimeh Hosseini, Ruth B Murray, David B Price

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Abstract

BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.

METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.

RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.

CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

Original language	English
Journal	Chest
Early online date	27 Nov 2019
DOIs	https://doi.org/10.1016/j.chest.2019.10.053
Publication status	Early online date - 27 Nov 2019

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Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)
Copyright 2019 Elsevier. This manuscript is distributed under a Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Accepted author manuscript, 326 KBLicence: CC BY-NC-ND

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Eileen, W., Wechsler, M. E., Tran, T. N., Heaney, L. G., Jones, R. C., Menzies-Gow, A. N., Busby, J., Jackson, D. J., Pfeffer, P. E., Rhee, C. K., Cho, Y. S., Canonica, G. W., Heffler, E., Gibson, P. G., Hew, M., Peters, M., Harvey, E. S., Alacqua, M., Zangrilli, J., ... Price, D. B. (2019). Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR). Chest. Advance online publication. https://doi.org/10.1016/j.chest.2019.10.053

@article{e66ad9460b924fd8b22fbeda53f94366,

title = "Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)",

abstract = "BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.",

author = "Wang Eileen and Wechsler, {Michael E} and Tran, {Trung N} and Heaney, {Liam G} and Jones, {Rupert C} and Menzies-Gow, {Andrew N} and John Busby and Jackson, {David J} and Pfeffer, {Paul E} and Rhee, {Chin Kook} and Cho, {You Sook} and Canonica, {G Walter} and Enrico Heffler and Gibson, {Peter G} and Mark Hew and Matthew Peters and Harvey, {Erin S} and Mariana Alacqua and James Zangrilli and Lakmini Bulathsinhala and Carter, {Victoria A} and Isha Chaudhry and Neva Eleangovan and Naeimeh Hosseini and Murray, {Ruth B} and Price, {David B}",

year = "2019",

month = nov,

day = "27",

doi = "10.1016/j.chest.2019.10.053",

language = "English",

journal = "Chest",

issn = "0012-3692",

publisher = "Elsevier Inc.",

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Eileen, W, Wechsler, ME, Tran, TN, Heaney, LG, Jones, RC, Menzies-Gow, AN, Busby, J, Jackson, DJ, Pfeffer, PE, Rhee, CK, Cho, YS, Canonica, GW, Heffler, E, Gibson, PG, Hew, M, Peters, M, Harvey, ES, Alacqua, M, Zangrilli, J, Bulathsinhala, L, Carter, VA, Chaudhry, I, Eleangovan, N, Hosseini, N, Murray, RB & Price, DB 2019, 'Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)', Chest. https://doi.org/10.1016/j.chest.2019.10.053

TY - JOUR

T1 - Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)

AU - Eileen, Wang

AU - Wechsler, Michael E

AU - Tran, Trung N

AU - Heaney, Liam G

AU - Jones, Rupert C

AU - Menzies-Gow, Andrew N

AU - Busby, John

AU - Jackson, David J

AU - Pfeffer, Paul E

AU - Rhee, Chin Kook

AU - Cho, You Sook

AU - Canonica, G Walter

AU - Heffler, Enrico

AU - Gibson, Peter G

AU - Hew, Mark

AU - Peters, Matthew

AU - Harvey, Erin S

AU - Alacqua, Mariana

AU - Zangrilli, James

AU - Bulathsinhala, Lakmini

AU - Carter, Victoria A

AU - Chaudhry, Isha

AU - Eleangovan, Neva

AU - Hosseini, Naeimeh

AU - Murray, Ruth B

AU - Price, David B

PY - 2019/11/27

Y1 - 2019/11/27

N2 - BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

AB - BACKGROUND: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and Asia/Pacific region.METHODS: The International Severe Asthma Registry (ISAR) retrospectively and prospectively collected data on severe asthma patients (≥18 years old), receiving GINA Step 5 treatment or remaining uncontrolled on GINA Step 4. Baseline demographic and clinical data were collected from the U.S., UK, South Korea, Italy, and the SAWD registry (including Australia, Singapore and New Zealand) from December 2014-December 2017.RESULTS: 4,990 patients were included. Average age was 55.0 (SD: 15.9) years, and age at asthma onset 30.7 (SD: 17.7) years. Patients were predominantly female (59.3%), white (72.6%), had never smoked (60.5%) and were over-weight/obese (70.4%). 34.9% were on GINA Step 5. 57.2% had poorly controlled disease. 51.1% of patients were on regular intermittent OCS and 25.4% were on biologics (72.6% for those on GINA Step 5). Mean exacerbation rate was 1.7 (SD: 2.7) per year. Inter-country variation was observed in clinical characteristics, prescribed treatments and biomarker profiles.CONCLUSIONS: Using a common dataset and definitions, this study is the first to describe severe asthma characteristics of a large cohort of patients included in multiple severe asthma registries, and to identify country differences. Whether these are related to underlying epidemiological, environmental factors, phenotype, asthma management systems, treatment access and/or cultural factors requires further study.

U2 - 10.1016/j.chest.2019.10.053

DO - 10.1016/j.chest.2019.10.053

M3 - Article

C2 - 31785254

SN - 0012-3692

JO - Chest

JF - Chest

ER -

Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR)

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