P193 Quantifying the unmet need in severe asthma: An analysis of the number of untreated biologic eligible patients in the UK. (11th November 2022)

• Record Type: Journal Article
• Authors: Dhruve, H; Haigh, M; Nanzer, AM; Jackson, DJ
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A185
• Page End: A185
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.327
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction: Biologic therapies have transformed the lives of patients with severe asthma, however >70% of patients with suspected severe asthma are yet to be referred to secondary care 1 . Several commercial companies have provided assessments of the number of biologic-eligible asthma patients in the UK to quantify unmet need. However, these assessments have assumed adequate ICS adherence, that the OCS prescription was indeed for asthma versus a co-morbidity, and that it is taken when prescribed versus stored as a rescue pack. As such, a more accurate assessment taking into account these factors is required to allow adequate planning of specialist services. Methods: A single primary care network (PCN) in London covering a population of 53888 individuals was chosen to establish the number of biologic eligible adult patients. An EMIS web search was used to identify asthmatics on the National QoF register who had been issued ³2 OCS in 2021. These were cross-checked with local hospital emergency department attendances to identify patients who had been issued a total of ³ 3 OCS over the year and therefore meeting NICE biologic eligibility thresholds. ICS prescription records were reviewed to confirm adequate (75%) ICS adherence. The primary care consultation notes of each patient meeting this threshold was reviewed to confirm that the OCS was prescribed for asthma rather than a co-morbidity, and patients were then contacted to confirm they had taken the OCS they were prescribed. Patients already prescribed biologic therapy for asthma within the PCN were also identified. Results: Within the PCN population, 2473/53888 (4.6%) adults with asthma were identified. 129/2473 (5.2%) had been issued ³2 OCS or were already prescribed a biologic (n=7). 38/129 (29.5%) were excluded as the OCS was prescribed for a comorbidity other than asthma. 51/129 biologic-naïve patients had ³3 confirmed exacerbations, however, only 31/51 had sufficient ICS dose and/or adherence. 28/31 had biomarker levels appropriate for a NICE approved biologic. Conclusion: Considering key confounding factors including ICS adherence, 1.4% of patients with asthma fulfil criteria for biologic therapy. At present, 80% of these are yet to be initiated on treatment. References: Ryan D, Heatley H, Heaney LG, Jackson DJ, Pfeffer PE, Busby J, et al . Potential Severe Asthma Hidden in UK Primary Care. J Allergy Clin Immunol Pract . 2021 Apr;9 (4):1612–1623.e9.