BIOLOGIC OUTCOMES AMONG ADULTS WITH SEVERE ASTHMA BY AGE OF ONSET: Results: FROM CHRONICLE

IntroductionMultiple biologic therapies are available for patients with severe asthma (SA) in the United States (US). However, effectiveness of biologics can vary by patient age at asthma onset, likely due to associations with allergic (earlier-onset) and eosinophilic (later-onset) inflammation. We examined real-world outcomes before and after biologic initiation among US subspecialist-treated adults with SA, as a function of asthma diagnosis age.MethodsCHRONICLE is an ongoing observational study of US adults with subspecialist-treated confirmed SA. Patients who started a biologic and had complete data for 6 months before and after biologic initiation from February 2018 to February 2022 were evaluated. A locally estimated scatterplot smoothing (LOESS) analysis was conducted to plot the correlation between percentage exacerbation rate reduction and age at asthma onset for each biologic class.ResultsThe analysis included patients with ≥1 exacerbation 6 months pre-biologic initiation (anti-IgE: n=64; anti–IL-5/5R/4R: n=198). Most patients were female, White, commercially insured, and had other comorbidities. LOESS plot curves showed generally similar rate reduction percentages between anti-IgE and anti–IL-5/5R/4R subgroups at younger asthma onset ages. However, reduced to no benefit was observed in the anti-IgE group who had asthma onset at age > 40 years (Figure).ConclusionAmong subspecialist-treated SA patients, reductions in exacerbations varied by patient age of onset and biologic class. Age of onset should be considered in biologic treatment decisions, particularly with use of anti-IgE in patients with asthma onset at age > 40 years.