A retrospective observational study to characterize severe eosinophilic asthma in Taiwan

Abstract

Background: Severe eosinophilic asthma (SEA) is an important asthma phenotype that is poorly described in clinical practice in Asia.

Aim and objectives: To characterize the epidemiology, medication dispensation and healthcare resource utilization (HRU) of adult SEA patients in Taiwan.

Methods: This retrospective cohort study was carried out within Taichung Veterans General Hospital’s electronic medical record database. Asthma patients aged ≥18 years were identified from 1Jul13-30Jun16. Patients were classified as having SEA if the following criteria were met at baseline: Prescription per GINA Step 4/5 treatment guidelines, 2+ exacerbations, and a blood eosinophil (EOS) count of ≥300 cells/µL or ≥150 cells/µL at baseline. Patients were followed for 1 year post index to examine medication use, HRU and related costs.

Results: Of 2,601 eligible asthma patients, 162 (6.2%) patients met the eligibility criteria for SEA. Higher prevalence of SEA was found in current or past smokers (23.5% vs. 16.0%, P=0.0305). The median blood EOS count for SEA patients was higher compared with those without SEA (467.5 cells/µl vs. 167.3 cells/µl, p<0.0001). SEA patients had more occurrence of 3+ comorbidities (27.2% vs. 14.0%, P<0.0001) and episodes of exacerbations than non-SEA (1.6±3.32 vs. 0.6±2.02, P=0.0002). The SEA patients were associated with longer length of stay for all-cause inpatient visits (9.2±1.30 vs. 2.8±0.20 days, P<0.0001), and accounted for higher all-cause total costs than non-SEA cohort (US$6,517.8 vs. US$2,782.8).

Conclusions: Although the overall prevalence of SEA was low in this cohort, these patients accounted for higher health care resources than general asthma patients. Funding: GSK (PRJ2409)