Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR)

作者：Florence Schleich, Désirée Larenas‐Linnemann, Alan Altraja, Luis Pérez de Llano, Κonstantinos Κostikas, Mohsen Sadatsafavi, Arnaud Bourdin, Roy A. Pleasants, Mark Hew, Wenjia Chen, Libardo Jiménez-Maldonado, Simon Couillard, Charlotte Suppli Ulrik, Adeeb A. Bulkhi, Ming‐Ju Tsai, George Christoff, Nikolaos G. Papadopoulos, Paul Pfeffer, Dermot Ryan, Céline Bergeron, Mona Al‐Ahmad, Delbert R. Dorscheid, Eileen Wang, John Blakey, Belinda Cochrane, Matthew Peters, Todor A. Popov, Carlos A. Torres‐Duque, Susanne Hansen, Francesca Puggioni, Kirsty Fletton, Laila Salameh, Peter G. Middleton, Paulo Márcio Pitrez, Chin Kook Rhee, Eve Denton, Kenneth R. Chapman, Lauri Lehtimäki, Ruth Murray, Chau‐Chyun Sheu, David J. Jackson, Riyad Al‐Lehebi, Mariko Siyue Koh, Bassam Mahboub, Ledit Ardusso, Athena Gogali, Giorgio Walter Canonica, Piotr Kuna, Martín Sívori, Renaud Louis, Shelley Abercromby, Giuseppe Guida, Bernt Bøgvald Aarli, Aaron Beastall, Victoria Carter, Ghislaine Scélo, John Townend, Borja G. Cosío, Pujan H. Patel, Celine Goh, Zsuzsanna Csoma, John W. Upham, João Fonseca, Peter G. Gibson, Christine Jenkins, Guy Brusselle, Anne Chèvremont, Andréanne Côté, Carlos Andrés Celis-Preciado, Iván Solarte, Celeste Porsbjerg, Asger Sverrild, Paula Kauppi, Stelios Loukides, Μichael Μakris, Andriana Ι. Papaioannou, Enrico Heffler, Jeffrey Shi Kai Chan, Hyonsoo Joo, Liam G. Heaney, Wei‐Han Cheng, Njira Lugogo, Michael E. Wechsler, Cláudia Chaves Loureiro, Bellanid Rodríguez-Cáceres, Tatsuya Nagano, Zhixiao Wang, Hao‐Chien Wang, Jorge Máspero, Fernando Saldarini, Ana María Stok, Anahí Yáñez, Philip G. Bardin, Sinthia Bosnic‐Anticevich, Vidya Navaratnam, Mohit Bhutani, M. Diane Lougheed, Lyle Melenka, Petros Bakakos, Konstantinos Exarchos, Aggelos Ladias, Dóra Lúðvíksdóttir, Takashi Iwanaga, Elvia Angelica Contreras Contreras, Sverre Lehmann, José Alberto Ferreira, Rebecca Gall, Pin‐Kuei Fu, Diahn‐Warng Perng, Flavia Hoyte, Rohit Katial, Unnur Steina Björnsdóttir, Camille Taillé, Christian Taube, Breda Cushen, Lakmini Bulathsinhala, Leif Bjermer, David Price · 发表于：World Allergy Organization Journal · 年份：2025 · DOI：10.1016/j.waojou.2025.101066 · 被引用次数：5 · 研究领域：Asthma and respiratory diseases、Delphi Technique in Research、Inhalation and Respiratory Drug Delivery

Background: Asthma characterization using blood eosinophil count (BEC) (among other biomarkers and clinical indices) is recommended in severe asthma (SA), but the masking effect of oral corticosteroids (OCS), makes this challenging. Aim: Our aim was to explore the effect of OCS use (both intermittent [iOCS] and long-term [LTOCS]) prior to biologic initiation on SA phenotype and biomarker profile in real-life and to characterize the burden of SA among patients prescribed LTOCS by biomarker profile. Methods: This was a registry-based cohort study, including data from 23 countries collected between 2003 and 2023 and shared with the Internatonal Severe Asthma Registry (ISAR). Patients with SA were categorized into 3 cohorts, those with: (i) no prescription for OCS, (ii) prescription(s) for iOCS (ie, ≤90 days in previous 12-months, usually short courses for exacerbations), and (iii) prescriptions for LTOCS (ie, >90 days in previous 12-months). Biomarker distribution (ie, BEC, fractional exhaled nitric oxide [FeNO], and total Immunoglobulin E [IgE]) were quantified in the year prior to biologic initiation in patients with SA according to OCS prescription pattern. Phenotypes were characterized for those prescribed LTOCS according to BEC cut-off (<150 and ≥ 150 cells/μL). Results: Of 4305 patients included, 5.0% (n = 215), 54.1% (n = 2330) and 40.9% (n = 1760) were prescribed no OCS, iOCS, and LTOCS, respectively. The BEC distribution varied by prescription pattern and LTOCS dose (<5...