D3.147 - A Survey of Approaches to Inhaled Therapy Management in Patients with Severe Asthma Treated with Biologics: Practices Among REIMAGINE Study Sites

Treatment adherence and correct use of medications such as inhaled corticosteroids (ICS) are key to achieving asthma remission; however, information on clinical practices to monitor adherence and taper ICS dose is limited. This survey aimed to understand the approach of REIMAGINE study sites to treatment adherence and ICS dose-tapering practices. These findings will inform study design and data interpretation for the REIMAGINE study (GSK ID: 219871).  

A survey containing 7 questions on treatment adherence and ICS dose-tapering was emailed to 88 REIMAGINE study investigators globally, ahead of study initiation. Surveys were reviewed with a site management associate via phone at initiation. Survey responses were free text and sent to the site management associate and transcribed into a tracker. All relevant information was included in the descriptive analysis. Survey results did not impact study site selection. 

Of 88 investigating physicians invited to complete the survey, 84 investigators from 9 countries submitted responses; not all responded to every question. Most physicians were pulmonologists (57%) or allergists (26%). To identify barriers to treatment adherence (N=75 respondents), most investigators used patient interviews (63%), with some physicians using medication/pharmacy record review (31%) and review of treatment affordability (11%). Assessments of patient-reported outcomes (25%), spirometry (12%) and biomarker (FeNO) analysis (7%) were reported as tools used to evaluate treatment adherence (Table). Strategies used to improve treatment adherence included education on the importance of adherence (32% of N=81) and inhaler technique (23% of N=81). Most investigators considered tapering ICS doses for patients with asthma control on biologics (89% of N=84; Table), with the most used criteria for tapering decisions being stable asthma control for 3–6 months (69% of N=29) and >6–12 months (24% of N=29). When determining the time and method for ICS tapering, the most frequently used guidelines were the Global Initiative for Asthma guidelines (64% of N=70), with multiple physician responses describing ICS tapering as a gradual step-down approach.

These results highlight a reliance on patient self-reported treatment adherence. Most physicians considered reviewing ICS dose requirements and subsequent tapering for patients on biologic treatment with controlled asthma over a defined period. 

Funding: GSK (219871)