Does Severe Asthma Affect HRQoL and Productivity in the Real-World Setting?

Woman coughing. Curly red-haired woman coughing because of flu while working

Patients with severe asthma experience significantly lower health-related quality of life (HRQoL) and productivity, but there are no HRQoL and productivity estimates from a real-world sample of patients with severe asthma in the United States. Data from the ongoing CHRONICLE study were published as part of the AAAAI Annual Meeting.

CHRONICLE is a real-world observational study of U.S. patients with severe asthma treated by allergists/immunologists or pulmonologists. Patients were eligible if they were receiving biologics, uncontrolled on high-dosage inhaled corticosteroids with additional controllers (HD ICS+), and/or maintenance systemic corticosteroids (mSCS). Patients are asked to fill out the St. George’s Respiratory Questionnaire (SGRQ; referencing prior three months; range 0-100, 100=maximum impairment) and Work Productivity and Activity Impairment-Asthma survey (WPAI; referencing prior seven days; percentage impairment) at baseline. Patients were stratified by treatment category, and responses for patients who joined the study from February 2018 through February 2019 were summarized.

There were 796 patients recruited from 89 sites, of whom 481 (60%) completed both surveys: biologic patients, n=370; HD ICS+ patients, n=91; and mSCS patients, n=64. Demographics and other patient characteristics did not largely differ between those who did and did not complete the surveys. Mean total SGRQ scores were: biologics, 39; HD ICS+, 45; and mSCS, 58; good or very good health was reported by 54%, 55%, and 19% of patients, respectively. Mean activity impairment per WPAI was 31%, 38%, and 55%, respectively. Mean overall work impairment among employed patients (biologics, 55%; HD ICS+, 53%; and mSCS, 38%) was 19%, 26%, and 38%, respectively.

“U.S. [patients with severe asthma] had reduced HRQoL and productivity, with greater impairment among those receiving mSCS and less among those receiving biologics. Rates of patient-reported good health were similar among biologic and HD ICS+ patients despite HRQoL and productivity differences, suggesting patient-reported health may mask meaningful impairment,” the researchers summarized.

https://www.jacionline.org/article/S0091-6749(19)32012-3/fulltext