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Investigating the Association Between Biologic Initiation and Medication Adherence in Severe Asthma: An Analysis of Linked Data
,
Liam G. Heaney,
P. Jane McDowell,
Gwyneth Davies ,
Claire Butler,
Joan Sweeney,
John Busby
The Journal of Allergy and Clinical Immunology: In Practice, Volume: 13, Issue: 10, Pages: 2626 - 2633.e8
Swansea University Author:
Gwyneth Davies
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DOI (Published version): 10.1016/j.jaip.2025.06.029
Abstract
Background: Poor adherence to inhaled therapy is common among patients with asthma. Findings from previous studies exploring inhaled corticosteroid (ICS) adherence in biologic-treated populations are inconsistent and have not investigated the long-term outcomes. Objective: To assess the long-term im...
| Published in: | The Journal of Allergy and Clinical Immunology: In Practice |
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| ISSN: | 2213-2201 2213-2198 |
| Published: |
Elsevier BV
2025
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa70392 |
| Abstract: |
Background: Poor adherence to inhaled therapy is common among patients with asthma. Findings from previous studies exploring inhaled corticosteroid (ICS) adherence in biologic-treated populations are inconsistent and have not investigated the long-term outcomes. Objective: To assess the long-term impact of introducing biologics on ICS/long-acting β2-agonist (LABA) adherence and to investigate the effect of poor ICS/LABA adherence on clinical outcomes among biologic-treated patients. Methods: A retrospective cohort study of adults who attended the Northern Ireland Regional Severe Asthma center between September 2015 and November 2021 was performed. Medication possession ratios (MPRs) for ICS/LABA medication were calculated using community dispensing records. Good adherence was defined as an MPR ≥75%. We compared adherence before and after biologic initiation, examined the correlates of adherence, and used multivariable longitudinal models to assess the impact of adherence on asthma outcomes. Results: Of 207 included patients, 58 (28.0%) had suboptimal adherence before biologic initiation. This was associated with higher deprivation (43.1% vs 25.2%; P = .012) and fractional exhaled nitric oxide (50 vs 32 parts per billion; P = .043). Population-level MPRs were stable during the study; however, adherence varied for individual patients. A total of 69 (33.3%) patients had poor adherence 1 year after biologic initiation. Although a substantial reduction in exacerbation rates was seen for both groups after biologic initiation, those with good adherence had an additional 17.4% (95% confidence interval: 2.2%, 30.2%) reduction in exacerbations compared with those with poor adherence. We found no difference in asthma symptoms or lung function. Conclusions: The introduction of biologics had little impact on population-level adherence; however, there were substantial changes for individual patients. Good adherence to ICS/LABA was associated with lower exacerbation rates among biologic-treated patients with severe asthma. |
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| Keywords: |
Asthma; Treatment adherence and compliance; Biological therapy |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Issue: |
10 |
| Start Page: |
2626 |
| End Page: |
2633.e8 |