{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:33:39Z","timestamp":1786527219809,"version":"build-2736575974"},"reference-count":84,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"GSK","award":["GSK ID: 217453"],"award-info":[{"award-number":["GSK ID: 217453"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Biologic therapy uptake for poorly controlled severe asthma is suboptimal despite guideline recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate real-world biologic initiation trends and predictors among patients with severe uncontrolled asthma (SUA) and SUA with eosinophilic phenotype (SUA-EP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective real-world cohort study that used Komodo Health administrative claims to identify US patients with SUA (controller\/rescue medication use and \u2a7e2 asthma exacerbations in a year) and a subgroup of patients with SUA-EP (blood eosinophil count \u2a7e150\u2009cells\/\u00b5L in the year pre- or post-exacerbation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Biologic initiation trends following first asthma exacerbation were assessed, and factors associated with lack of biologic initiation following second exacerbation (SUA-EP only) were identified using LASSO regression models; odds ratios (OR), 95% confidence intervals (CIs), and\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -values were calculated using logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Biologic initiation rates following the first exacerbation were low at 12.7% (4360\/34,246) and 12.2% (309\/2526) of patients with SUA and SUA-EP, respectively; mean time between second exacerbation and initiation was 13.4 and 11.9\u2009months. Predictors of lack of biologic initiation included young age (12\u201317\u2009years; OR (95% CI) 3.65 (1.69\u20137.89)), primary care physician specialty at index relative to respiratory specialist (2.89 (2.04\u20134.10)), and antibiotic use (2.29 (1.44\u20133.66); all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), indicating that younger patients, those managed by primary care and those treated with antibiotics for exacerbations, were less likely to receive biologics. Biologic initiation was more likely among patients with a cumulative systemic corticosteroid dose \u2a7e500\u2009mg (prednisone equivalent; 0.38 (0.25\u20130.57)), those using leukotriene modifiers (0.42 (0.28\u20130.62)) or single-inhaler triple therapy (0.06 (0.01\u20130.40)), and those with eosinophilic disorders (0.19 (0.07\u20130.52); all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite eligibility, most patients with SUA and SUA-EP did not receive any biologic; younger age and primary care management were predictors of lack of biologic initiation. This highlights the need for improved specialist referral and biologic uptake.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261459926","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:13:03Z","timestamp":1786345983000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rate and predictors of biologic initiation in patients with severe asthma: a retrospective cohort study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3260-9630","authenticated-orcid":false,"given":"John J.","family":"Oppenheimer","sequence":"first","affiliation":[{"name":"Pulmonary and Allergy Associates, Department of Internal Medicine, Rutgers New Jersey Medical School, 150 Bergen Street, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8650-7114","authenticated-orcid":false,"given":"Tom","family":"Corbridge","sequence":"additional","affiliation":[{"name":"GSK, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Stach-Klysh","sequence":"additional","affiliation":[{"name":"GSK, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Germain","sequence":"additional","affiliation":[{"name":"Analysis Group, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean D.","family":"MacKnight","sequence":"additional","affiliation":[{"name":"Analysis Group, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Boudreau","sequence":"additional","affiliation":[{"name":"Analysis Group, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Lalibert\u00e9","sequence":"additional","affiliation":[{"name":"Analysis Group, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arijita","family":"Deb","sequence":"additional","affiliation":[{"name":"GSK, Upper Providence, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"World Health Organization. Asthma https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/asthma. (accessed February 2024)."},{"key":"e_1_3_4_3_2","unstructured":"Global Initiative for Asthma. Global strategy for Asthma Management and Prevention https:\/\/ginasthma.org\/2026-gina-strategy-report\/ (2026 accessed May 2026)."},{"key":"e_1_3_4_4_2","unstructured":"Centers for Disease Control and Prevention. 2021 National Health Interview Survey (NHIS) data https:\/\/www.cdc.gov\/asthma\/nhis\/2021\/table3-1.htm (accessed February 2024)."},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00202013"},{"key":"e_1_3_4_6_2","first-page":"847","article-title":"Severe asthma: definition, diagnosis and treatment","volume":"111","author":"Lommatzsch M","year":"2014","unstructured":"Lommatzsch M, Virchow JC. Severe asthma: definition, diagnosis and treatment. Deutsches Arzteblatt Int 2014; 111: 847\u2013855.","journal-title":"Deutsches Arzteblatt Int"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2017.1316394"},{"key":"e_1_3_4_8_2","first-page":"825","article-title":"Incremental cost burden among patients with severe uncontrolled asthma in the United States","volume":"29","author":"Burnette A","year":"2023","unstructured":"Burnette A, Wang Y, Rane PB, et al. Incremental cost burden among patients with severe uncontrolled asthma in the United States. J Manag Care Spec Pharm 2023; 29: 825\u2013834.","journal-title":"J Manag Care Spec Pharm"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201901-0016OC"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2018.1455858"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.04.013"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13841"},{"key":"e_1_3_4_13_2","unstructured":"US prescribing information. XOLAIR (omalizumab) for injection for subcutaneous use 2023 https:\/\/www.gene.com\/download\/pdf\/xolair_prescribing.pdf (accessed January 2024)."},{"key":"e_1_3_4_14_2","unstructured":"US prescribing information. NUCALA (mepolizumab) for injection for subcutaneous use 2023 https:\/\/gskpro.com\/content\/dam\/global\/hcpportal\/en_US\/Prescribing_Information\/Nucala\/pdf\/NUCALA-PI-PIL-IFU-COMBINED.PDF (accessed January 2024)."},{"key":"e_1_3_4_15_2","unstructured":"US prescribing information. CINQAIR (reslizumab) injection for intravenous use 2020 https:\/\/www.cinqair.com\/globalassets\/cinqair\/prescribinginformation.pdf (accessed January 2024)."},{"key":"e_1_3_4_16_2","unstructured":"Sanofi. FDA approves asthma indication for Dupixent\u00ae (dupilumab) https:\/\/www.news.sanofi.us\/2018-10-19-FDA-approves-asthsma-indication-for-Dupixent-R-dupilumab (2018 accessed May 2026)."},{"key":"e_1_3_4_17_2","unstructured":"US prescribing information. FASENRA (benralizumab) injection for subcutaneous use 2019 https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/761070s000lbl.pdf (accessed January 2024)."},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S328653"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1403291"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25010182"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2020.100464"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S303841"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S134300"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201904-0903SO"},{"key":"e_1_3_4_25_2","article-title":"Recognising the long-term burden of short course oral corticosteroids","volume":"58","author":"Heaney LG","year":"2021","unstructured":"Heaney LG, Schleich F, Korn S, et al. Recognising the long-term burden of short course oral corticosteroids. Eur Respir J 2021; 58: PA3548.","journal-title":"Eur Respir J"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S176026"},{"key":"e_1_3_4_27_2","article-title":"Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study","volume":"357","author":"Waljee AK","year":"2017","unstructured":"Waljee AK, Rogers MA, Lin P, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ 2017; 357: j1415.","journal-title":"BMJ"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50758"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2020.1748048"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2011.09.009"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2021.100528"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2025.108312"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01521-2023"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2020.1748049"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.12.027"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_37_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2016 accessed May 2026)."},{"key":"e_1_3_4_38_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2015 accessed May 2026)."},{"key":"e_1_3_4_39_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2017 accessed May 2026)."},{"key":"e_1_3_4_40_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2018 accessed May 2026)."},{"key":"e_1_3_4_41_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2020 accessed May 2026)."},{"key":"e_1_3_4_42_2","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention https:\/\/ginasthma.org\/archived-reports\/ (2022 accessed May 2026)."},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-023-00767-6"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2021.42.200101"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2021.100600"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2021-217032"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2022.101882"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2023.44.230061"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2023.08.016"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.12920"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-024-00917-4"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ec173d"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2022-219642"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00151-2020"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02420-2019"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212233"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.12.813"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpam.2019.02.001"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.08.024"},{"key":"e_1_3_4_60_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2019.1595966"},{"key":"e_1_3_4_61_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401389"},{"key":"e_1_3_4_62_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S491447"},{"key":"e_1_3_4_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.07.034"},{"key":"e_1_3_4_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.02.031"},{"key":"e_1_3_4_65_2","article-title":"Characteristics of new adult users of mepolizumab with asthma in the USA","volume":"8","author":"Wu AC","year":"2021","unstructured":"Wu AC, McMahon PM, Welch E, et al. Characteristics of new adult users of mepolizumab with asthma in the USA. BMJ Open Respir Res 2021; 8: e001003.","journal-title":"BMJ Open Respir Res"},{"key":"e_1_3_4_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2023.07.017"},{"key":"e_1_3_4_67_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00314-2025"},{"key":"e_1_3_4_68_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00588-2019"},{"key":"e_1_3_4_69_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-021-01767-z"},{"key":"e_1_3_4_70_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04605-2020"},{"key":"e_1_3_4_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2023.01.002"},{"key":"e_1_3_4_72_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0269-2024"},{"key":"e_1_3_4_73_2","doi-asserted-by":"publisher","DOI":"10.1111\/all.16002"},{"key":"e_1_3_4_74_2","doi-asserted-by":"publisher","DOI":"10.1111\/all.15867"},{"key":"e_1_3_4_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00293-5"},{"key":"e_1_3_4_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.01.039"},{"key":"e_1_3_4_77_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23220"},{"key":"e_1_3_4_78_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.09.063"},{"key":"e_1_3_4_79_2","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0905"},{"key":"e_1_3_4_80_2","article-title":"Mepolizumab for chronic rhinosinusitis with nasal polyps: Treatment efficacy by comorbidity and blood eosinophil count","volume":"149","author":"Bachert C","year":"2022","unstructured":"Bachert C, Sousa AR, Han JK, et al. Mepolizumab for chronic rhinosinusitis with nasal polyps: Treatment efficacy by comorbidity and blood eosinophil count. J Allergy Clin Immunol 2022; 149: 1711\u20131721.e6.","journal-title":"J Allergy Clin Immunol"},{"key":"e_1_3_4_81_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.07.024"},{"key":"e_1_3_4_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.07.047"},{"key":"e_1_3_4_83_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-020-00330-1"},{"key":"e_1_3_4_84_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S391896"},{"key":"e_1_3_4_85_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.03.042"}],"container-title":["Therapeutic Advances in Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261459926","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17534666261459926","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261459926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T08:56:00Z","timestamp":1786524960000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17534666261459926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":84,"alternative-id":["10.1177\/17534666261459926"],"URL":"https:\/\/doi.org\/10.1177\/17534666261459926","relation":{"has-review":[{"id-type":"doi","id":"10.1177\/17534666261459926\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v4\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v4\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v4\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666261459926\/v3\/review1","asserted-by":"object"}]},"ISSN":["1753-4666","1753-4666"],"issn-type":[{"value":"1753-4666","type":"print"},{"value":"1753-4666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"17534666261459926"}}