Study Highlights Uneven Symptom Burden in Patients With Uncontrolled vs Controlled Severe Asthma

When assessing the symptom burden among individuals with uncontrolled severe asthma and controlled severe asthma, greater impairment to health status and lower productivity was associated in those with uncontrolled severe asthma.

“This global, real-world analysis highlights the symptom burden and productivity loss associated with uncontrolled severe asthma.... This study provides a novel setting, with patients recruited from clinical practice in primary and specialist care, and with physician-assigned diagnosis and physician-assessed severity, reflecting real-world physician perspectives,” wrote the researchers of the study.

The full analysis from the from the novel observational longitudinal study (NOVELTY) is published in the Journal of Asthma and Allergy.

Prior studies identified the burden of asthma, health status, and productivity loss in patients with uncontrolled vs controlled severe asthma. However, few studies have examined this burden across multiple primary and specialty care settings around the world. This current analysis study aimed to do so using real-world patient data from the NOVELTY study, which included patient data from health centers in 19 countries across North America, South America, Asia, Australia, and Europe.

The NOVELTY study included patients 18 years and older, or 12 years and older who had been diagnosed with asthma, chronic obstructive pulmonary disease (COPD), or both. Uncontrolled severe asthma was defined as having an Asthma Control Test (ACT) score less than 20 and/or having physician reported severe exacerbations in the previous year from baseline evaluation. On the other hand, controlled severe asthma was defined as having an ACT score of 20 or greater and no physician-reported exacerbations in the previous year.

The researchers of this analysis also included data from patient-reported health assessments, such as the Respiratory Symptoms Questionnaire (RSQ), St. George’s Respiratory Questionnaire (SGRQ), EuroQoL 5 Dimensions 5 Levels Health Questionnaire (Eq-5D-5L) index value, and EQ-5D-5L Visual Analog Score (EQ-VAS) to evaluate symptom burden, health status, and productivity. These patient outcomes were collected online or by telephone at the time of, or shortly after baseline visit.

In total, the researchers identified 1078 patients with uncontrolled severe asthma and 315 patients with controlled severe asthma. Overall, patients with uncontrolled severe asthma had a higher symptom burden according to mean RSQ score (7.7 vs 2.5), worse health status with a mean SGRQ score 47.5 vs 22.4, mean EQ-5D-5L index value 0.68 vs 0.90, and a mean EQ-VAS score 64.1 vs 78.1, and lower productivity with presenteeism 29.3% vs 10.5%.

The researchers acknowledge some limitations in their analysis, including potential patient selection bias, variation in asthma and COPD diagnosis, and higher amounts of missing data for symptom burden, health status, and productivity in the uncontrolled severe asthma group compared with the controlled severe asthma group.

Despite these limitations, the researchers believe this study provides a better picture of the symptom burden, health status, and productivity loss among patients with uncontrolled and controlled severe asthma.

“These results support recommendations for interventions to achieve good asthma control in more patients with severe asthma, which would reduce its symptom burden and its substantial impact on patient health status and productivity,” wrote the researchers.

Reference

Ding B, Chen S, Srivastava D, et al. Symptom burden, health status, and productivity in patients with uncontrolled and controlled severe asthma in novelty. J Asthma Allergy. 2023;16:611-624. doi:10.2147/jaa.s401445