A Real World Study to Capture Clinical and Patient Centered Outcomes in Adults With Severe Eosinophilic Asthma Treated With Benralizumab.

AstraZeneca152 enrolled

Overview

Severe eosinophilic asthma (SEA) is associated with poor disease control and compromised health-related quality of life (HRQoL), leading to a substantial psychosocial and economic disease burden. Benralizumab (Fasenra®), an interleukin (IL)-5-alpha receptor monoclonal antibody, is approved as an add-on maintenance treatment for SEA. This study aims at collecting real-world data that extend beyond the clinical effectiveness of benralizumab to the participant-reported impact of treatment on their HRQoL, sleep quality, depression, anxiety, work productivity and activity impairment, but also on treatment effectiveness. Recent technological advances in portable spirometers and wearable activity trackers (WAT) to increase physical activity for participants with asthma, even for older participants, allow this study to collect data on lung function parameters and physical activity from such devices for the first time at a country level in Greece. Using a multi-aspect approach, this study will generate real-world evidence on a broad range of both well-established clinical and novel patient-centered outcomes which are critical to the assessment of the therapeutic benefit both from the physician's and the participant's perspective. All main study outcomes will be examined at various timepoints throughout the course of the 48-week observation period, starting as early as 4 weeks after treatment initiation, thus enabling the identification of 'early' treatment responders with a closer focus on patients' physical and psychological well-being and HRQoL in addition to asthma control and lung function metrics

Study Type

OBSERVATIONAL

Enrollment

152

Conditions

Severe Eosinophilic Asthma

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Male or female outpatients aged 18 to 75 years (inclusive) at the time of benralizumab prescription * Patients with physician-diagnosed Severe Eosinophilic Asthma SEA inadequately controlled despite high-dose inhaled corticosteroids (ICS) plus long-acting β-agonists (LABA) * Patients who have been prescribed but not yet initiated treatment with benralizumab according to the Summary of Product Characteristics (SmPC), prior to signed Informed Consent, and for whom the decision to prescribe this therapy is clearly separated from the physician's decision to include the patient in the current study * For patients that are not Oral Corticosteroid (OCS)-dependent: Blood eosinophil count (BEC) ≥150 cells/μL in the 2 weeks before benralizumab initiation and a historical value of ≥300 cells/μL during the previous year * For OCS-dependent patients: BEC ≥150 cells/μL in the 2 weeks before benralizumab initiation or a historical value of ≥300 cells/μL during the previous year * History of ≥1 documented Clinically Significant Exacerbations (CSE) in the 48 weeks prior to benralizumab initiation, and of ≥2 CSEs in the previous 24 months * Patients must be willing and able to read and complete the study specific questionnaires * Patients must be willing and able to use the study-specific wearable/handheld devices. Note: This requirement applies only at the time of benralizumab (Fasenra®) prescription. If a patient stops using any or both of the aforementioned devices for any reason during his/her participation in the study, (s)he may continue participating in the study and this will not be considered as a reason for withdrawal. -Patients must provide a written Informed Consent prior to inclusion to the study Exclusion Criteria: * Patients that meet any of the contraindications to the administration of the benralizumab outlined in the SmPC * Concomitant treatment with any other biologic agent for any indication * Previous exposure to anti-IL5/ILR5 treatment * Exposure to omalizumab in the past 6 months prior to benralizumab initiation * Clinically important pulmonary disease other than asthma or ever been diagnosed with any disease, other than asthma, that is associated with elevated BEC * Acute upper or lower respiratory infections within 8 weeks prior to the date of informed consent * Heavy smokers with a \>20 pack-year smoking history * Currently pregnant (or intention to become pregnant within the study period), breastfeeding or lactating women * Known evidence of lack of adherence to asthma controller medications * Use of immunosuppressive medication (including but not limited to: OCS \[for reasons other than asthma\], methotrexate, troleandomycin, cyclosporine, azathioprine, intramuscular long-acting depot corticosteroids \[for reasons other than asthma\] or any experimental anti-inflammatory therapy) within 3 months prior to the date of informed consent * Patients who currently receive treatment with any investigational drug/device/intervention or who have received any investigational product within 30 days or 5 half-lives of the investigational agent (whichever is longer) before benralizumab initiation

Locations (13)

Research Site

Alexandroupoli, Greece

Research Site

Athens, Greece

Research Site

Athens, Greece

Research Site

Athens, Greece

Research Site

Athens, Greece

Research Site

Athens, Greece

Research Site

Corfu, Greece

Research Site

Heraklion, Greece

Research Site

Ioannina, Greece

Research Site

Rio, Greece

...and 3 more locations

Outcomes

Primary Outcomes

Change in St. George's Respiratory Questionnaire (SGRQ)

Estimation of the proportion of patients achieving a minimum clinically important improvement in respiratory health status (≥ 4-point reduction from baseline in SGRQ total score) in SEA patients initiated on benralizumab

Time frame: 16 weeks after the initiation of the treatment

Secondary Outcomes

Change in St. George's Respiratory Questionnaire (SGRQ)

Estimation of the proportion of patients achieving a moderately efficacious change in respiratory health status (≥ 8-point reduction from baseline in SGRQ total score)

Time frame: 16 weeks after the initiation of the treatment

Change in St. George's Respiratory Questionnaire (SGRQ)

Estimation of the proportion of patients achieving a minimum clinically important improvement (≥ 4-point reduction in baseline SGRQ total score) and of those achieving a moderately efficacious change in respiratory health status (≥ 8-point reduction in baseline SGRQ total score)

Time frame: after 4, 8, 32 and 48 weeks of treatment

Change in St. George's Respiratory Questionnaire (SGRQ)

Determination of predictors of early clinically important improvement in respiratory health status (measured by the SGRQ) at 4 weeks of treatment with benralizumab, and at 48 weeks post-benralizumab initiation among the 4-week SGRQ responders

Time frame: after 4 and 48 weeks of treatment

Change in ACQ-6

Change in asthma control and the response rate as well as the response rate at 48 weeks post-benralizumab initiation among the 16-week ACQ-6 responders

Time frame: after 4, 8, 16, 32, and 48 weeks of treatment

Change in the annual rate of clinically significant exacerbations

Change in the annual rate of clinically significant exacerbations (CSE) and identification of factors influencing the CSE rate

Time frame: between the 48-week periods pre- and post-benralizumab initiation

change in asthma-related hospital-based health care resource utilization (HCRU)

Change in asthma-related hospital-based health care resource utilization (HCRU)

Time frame: between the 48-week periods pre- and post-benralizumab initiation

Change from baseline in clinic-measured spirometric lung function indices

Change from baseline in clinic-measured spirometric lung function indices and description of the FEV1 improvement rate at 48 weeks post-benralizumab initiation among patients who will achieve clinically meaningful improvement in FEV1 at 16 weeks post-benralizumab initiation

Time frame: after 16 and 48 weeks of benralizumab treatment

change from baseline in rescue medication use and in the proportion of nights with awakenings due to asthma requiring rescue medication use

Change from baseline in rescue medication use and in the proportion of nights with awakenings due to asthma requiring rescue medication use

Time frame: after 4, 8, 16, 32 and 48 weeks of treatment

change in cumulative oral corticosteroid (OCS) burden

Change in cumulative oral corticosteroid (OCS) burden

Time frame: etween the 16-week periods pre- and post-benralizumab initiation and the 48-week periods pre- and post-benralizumab initiation

change from baseline in anxiety and depression levels [assessed by the Hospital Anxiety and Depression Scale (HADS)]

Change from baseline in anxiety and depression levels \[assessed by the Hospital Anxiety and Depression Scale (HADS)\]

Time frame: after 16 and 48 weeks of treatment

change from baseline in patient-reported sleep quality [assessed by the Pittsburgh Sleep Quality Index (PSQI)]

Change from baseline in patient-reported sleep quality \[assessed by the Pittsburgh Sleep Quality Index (PSQI)\]

Time frame: after 16 and 48 weeks of treatment

change from baseline in work productivity and activity impairment [assessed by the Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire]

Change from baseline in work productivity and activity impairment \[assessed by the Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire\]

Time frame: after 16 and 48 weeks of treatment

clinician-assessed overall response to treatment using the Clinician Global Impression of Change (CGIC)

Clinician-assessed overall response to treatment using the Clinician Global Impression of Change (CGIC)

Time frame: over the 48-week treatment period

patient-perceived overall response to treatment using the Patient Global Impression of Change (PGIC)

Patient-perceived overall response to treatment using the Patient Global Impression of Change (PGIC)

Time frame: after 48 weeks of treatment

Percentage of patients remaining on treatment with benralizumab

Treatment persistence rate on therapy

Time frame: at 48 weeks of treatment

Percentage of patients having discontinued treatment with benralizumab

Time frame: at 48 weeks of treatment

description of reasons for treatment discontinuation

Time frame: at 48 weeks of treatment

time to treatment discontinuation

Time frame: at 48 weeks of treatment