REASONS WHY PATIENTS WITH SEVERE ASTHMA DISCONTINUE BIOLOGIC TREATMENT

Abstract

SESSION TITLE: Allergy and Airway Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: There is a growing body of evidence on adherence/dosing of biologic therapies for patients with severe asthma, but little is known about why patients discontinue therapy. Understanding the characteristics of patients who discontinue therapy and their reasons could aid physician identification of barriers to treatment success. This study uses physician and patient cross-sectional survey data to understand patient characteristics and reasons for discontinuation from a US patient cohort with severe asthma treated with a biologic. METHODS: This is a retrospective analysis using Adelphi Respiratory Disease Specific ProgrammeTM data which surveyed physicians and their patients from July to December 2019. Physicians completed questionnaires on disease management and case reports for their patients with severe asthma treated with a biologic. Patients completed questionnaires including demographic characteristics and perceptions of their disease and treatment. RESULTS: 117 physicians and 285 patients completed surveys with 70% of patients continuing biologic therapy (N=200). Among 85 physicians providing a rationale for discontinuation, the majority reported lack of symptom control (i.e. shortness of breath 46%; other chronic symptoms 29%; exacerbations 26%) and 27% listed cost/reimbursement. Conversely, guidelines/formulary changes (4%) and the availability of new therapies (1%) were rarely reported. Similar to physician responses, among the 64 patients who provided a reason for discontinuation, 45% reported lack of symptom control (i.e. breathing symptoms, other symptoms, flare ups) and 28% listed cost/insurance. Nearly half of patients reported “requesting the change in therapy” as the reason for discontinuation. By cohort, patients who continued therapy (N=200) versus those who ever discontinued a biologic (N=85) were slightly older (mean age 48 vs 44) and had a higher percentage of women (54% vs 47%). Comorbid conditions were similar with the exception of a higher percentage of allergic rhinitis (70% vs 62%), chronic rhinosinusitis (30% vs 13%) and anxiety/depression (23% vs 14%) among those continuing therapy versus those discontinuing. Satisfaction was higher among patients continuing therapy with 84% reporting being satisfied/very satisfied with therapy compared to 48% of patients who discontinued. CONCLUSIONS: Approximately a third of patients in this study ever discontinued biologic therapy. Lack of symptom control was the most frequent reason given by both physicians and patients for discontinuation, followed by cost/insurance issues. Patients who continued therapy were older with more frequent asthma-related comorbidities compared with those discontinuing treatment. CLINICAL IMPLICATIONS: These results reinforce the need for clinicians to regularly assess symptom control as well as the lack of insurance/coverage changes for patients treated with biologic therapy. DISCLOSURES: Employee relationship with GlaxoSmithKline Please note: >$100000 Added 03/03/2020 by Michael Bogart, source=Web Response, value=Salary Employee relationship with GlaxoSmithKline Please note: >$100000 Added 03/16/2020 by Beth Hahn, source=Web Response, value=Ownership interest No relevant relationships by Matt Hanson, source=Web Response Employee relationship with GSK Please note: $20001 - $100000 Added 03/17/2020 by Nestor Molfino, source=Web Response, value=Salary No relevant relationships by James Siddall, source=Web Response Employee relationship with GSK (GlaxoSmithKline) Please note: >$100000 Added 03/17/2020 by Jared Silver, source=Web Response, value=Salary Employee relationship with GSK (GlaxoSmithKline) Please note: $20001 - $100000 Added 03/17/2020 by Jared Silver, source=Web Response, value=Investments-Stock My spouse/partner as a Employee relationship with Change Healthcare Please note: >$100000 Added 03/17/2020 by Jared Silver, source=Web Response, value=Salary My spouse/partner as a Employee relationship with Change Healthcare Please note: $5001 - $20000 Added 03/17/2020 by Jared Silver, source=Web Response, value=Investments-Stock No relevant relationships by Mark Small, source=Web Response