AN UPDATED MODEL FOR PREDICTION OF ASTHMA EXACERBATIONS USING ALBUTEROL ELECTRONIC MULTI-DOSE DRY POWDER INHALER

Abstract

SESSION TITLE: Asthma: Mechanisms and Management SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: Early detection of an impending asthma exacerbation would provide opportunities for pre-emptive treatment and improve asthma action plans. A predictive model for impending asthma exacerbations was successfully developed using data from ProAir Digihaler (albuterol 90 µg), an electronic multi-dose dry powder inhaler with integrated sensors. Refinement with additional patient data could improve the predictive accuracy of the model. METHODS: This 12-week, open-label study enrolled patients (≥18 years old) with exacerbation-prone asthma. Patients used the Digihaler (1–2 inhalations every 4 hours) as needed, which recorded use and inhalation variables (peak inspiratory flow [PIF], inhalation volume, inhalation duration, and time to PIF). Case report form (CRF) data (demographics, medical history, and baseline vital signs), were combined with the Digihaler data and subjected to a machine learning algorithm to refine a model predictive of impending asthma exacerbations. The generated model was evaluated by receiver operating characteristic area under curve (ROC AUC) analysis. RESULTS: Patients with ≥1 valid inhalation (n=360) from the Digihaler were included in the analysis. Of these, 64 patients experienced a total of 78 asthma exacerbations. The refined predictive model included features from the CRF as well as albuterol usage patterns and inhalation parameters, and showed an ability to predict an impending exacerbation over the 5 days before an asthma exacerbation with a ROC AUC of 0.83 (sensitivity 68.8%, specificity 89.1%), compared with 0.75 previously from using Digihaler data only. CONCLUSIONS: Combining ProAir Digihaler data with CRF information enabled the improvement of the predictive model. Additional studies, and potentially including other data sources, will further refine the model. CLINICAL IMPLICATIONS: Data collected by the Digihaler could improve asthma management and enable pre-emptive interventions to minimize asthma exacerbations, improve quality of care, and reduce healthcare costs. DISCLOSURES: Employee relationship with Teva Please note: >$100000 Added 06/04/2020 by Randall Brown, source=Web Response, value=Salary Employee relationship with Tevapharmaceuticals Please note: >$100000 Added 06/01/2020 by Michael De Pietro, source=Web Response, value=Salary No relevant relationships by Lena Granovsky, source=Web Response Employee relationship with Teva Pharmaceuticals Please note: >$100000 Added 06/01/2020 by Tanisha Hill, source=Web Response, value=Salary no disclosure on file for Thomas Li; Advisory Committee Member relationship with Propeller Health Please note: $1-$1000 Added 06/01/2020 by Rajan Merchant, source=Web Response, value=Honoraria sold stock (< $300 value) in 11/2019 relationship with Electrocore Please note: $1-$1000 Added 06/15/2020 by Giselle Mosnaim, source=Web Response, value=sold stock Consultant relationship with Boehringer Ingelheim Please note: $1001 - $5000 Added 06/15/2020 by Giselle Mosnaim, source=Web Response, value=work done 2018; fee paid 2019 research grant to institution relationship with Propeller Health Please note: $5001 - $20000 Added 06/15/2020 by Giselle Mosnaim, source=Web Response, value=research grant to institution Removed 06/15/2020 by Giselle Mosnaim, source=Web Response research grant to institution relationship with Propeller Health Please note: $5001 - $20000 Added 06/15/2020 by Giselle Mosnaim, source=Web Response, value=research grant in 2020 Consultant relationship with Teva Please note: $1-$1000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Boehringer Ingelheim Please note: $5001 - $20000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Honoraria Advisory Committee Member relationship with Theravance Please note: $1-$1000 Added 04/29/2020 by Roy Pleasants, source=Web Response, value=Consulting fee No relevant relationships by Michael Reich, source=Web Response Employee relationship with Teva Pharmaceuticals Please note: >$100000 Added 06/01/2020 by Guilherme Safioti, source=Web Response, value=Salary