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Singapore, [25 June 2024] – A new analysis of data from the International Severe Asthma Registry (ISAR) has revealed a spectrum of responsiveness among real-world patients with severe asthma who initiated biologic asthma therapies, most of whom were ineligible to participate in randomized controlled trials. Although many biologic initiators responded well, with higher proportions achieving super-responses than responses, around 40–50% did not meet the response criteria (Figure 1). The study, " Real-world biologics response and super-response in the International Severe Asthma Registry cohort (LUMINANT)" , was conducted by the Observational and Pragmatic Research Institute (OPRI), partially funded by Optimum Patient Care Global Ltd. and AstraZeneca, and is published in Allergy (European Journal of Allergy and Clinical Immunology) . [1]   Figure 1. Proportions of super-responders, responders, and non-responders across single domains among patients who did or did not initiate a biologic asthma therapy Abbreviation: FEV 1 , Forced expiratory volume in 1 second.   “Until now, there have been limited data on the outcomes of biologic asthma therapies outside of selected randomized controlled trial cohorts”, said Professor David Price, corresponding author, and Director of OPRI. “The LUMINANT study gives new insights affirming the effectiveness of biologic asthma therapies in the broader real-world severe asthma population, which is much more heterogenous. However, unmet treatment needs clearly remain, as half of the patients who initiated biologic therapies responded sub-optimally.”   ISAR Includes electronic medical records from 20,000 patients with severe asthma in 28 countries worldwide. This study grouped 8446 eligible adults with ≥24 weeks of follow-up into those who did or did not initiate biologic asthma therapies, and examined their treatment responses across four single outcome domains: forced expiratory volume in 1 second (FEV 1 ) increase by ≥100 mL, improved asthma control, annualized exacerbation rate reduction ≥50%, and any reduction in use of long-term oral corticosteroids (LTOCS). The corresponding criteria defining super-responses were: FEV 1 increase by ≥500 mL, new well-controlled asthma, no exacerbations, and LTOCS cessation or tapering to ≤5 mg/day.   Only 5.3% of patients in this study met standard randomized controlled trial inclusion criteria. Proportionally more biologic initiators had super-responses than responses (except for FEV 1 ) and responses/super-responses were more frequent in biologic initiators than in non-initiators; nevertheless, ~40–50% of initiators did not meet response criteria (Figure 1).   “It is encouraging to affirm that biologic therapies can improve outcomes for many patients with severe asthma in real-world settings”, said the lead investigator Professor Eve Denton. “However, there were no complete responses to the biologics used in these patients,  highlighting persisting unmet treatment needs. Our findings justify research to determine whether initiating biologics earlier may increase the likelihood of achieving a treatment response.”   To learn more about the study, please read the full publication  in Allergy  (Official journal of the European Academy of Allergy and Clinical Immunology), as well as the accompanying slide deck .   The Observational and Pragmatic Research Institute (OPRI) is an independent, internationally recognised research organisation which conducts studies that provide real-world evidence to support best practices for chronic disease management in primary care and make a difference to patients. https://www.opri.org.uk/   The International Severe Asthma Registry (ISAR) is operated by Optimum Patient Care Global Ltd. (OPCG) and co-funded by OPCG and AstraZeneca.   To learn more please visit our website: www.isar.opcglobal.org .   Reference 1.   Denton E, Hew M, Peters MJ, Upham JW, Bulathsinhala L, Tran TN, et al. Real-world biologics response and super-response in the International Severe Asthma Registry cohort. Allergy 2024:  http://doi.org/10.1111/all.16178

The EVEREST study published in the Journal of Asthma and Allergy , “Disease Burden and Access to Biologic Therapy in Patients with Severe Asthma, 2017–2022: An Analysis of the International Severe Asthma Registry” , has shed light on the significant global disease burden faced by patients suffering from severe asthma, including those without access to biologic therapies, those who were eligible but did not receive these treatments, and T2-targeted biologic recipients. The findings underscore the urgent need for improved healthcare resource utilization, increased access to biologics, and ongoing research on new treatment options to address the unmet needs of patients with severe asthma. Approximately 55% of patients who lacked access to biologics and 71% of patients who had access but did not receive biologics had uncontrolled asthma (Figure 1). Among T2-targeted biologic recipients, approximately one-third still had uncontrolled asthma and one-fifth experienced ≥2 exacerbations in the 12 months post-biologic initiation (Figure 2). Two-thirds of T2-targeted biologic recipients had asthma that remained suboptimally controlled despite biologic treatment. Figure 1. Proportions of patients with severe asthma who experienced ≥2 exacerbations, had uncontrolled asthma and received LTOCS during the 12 months before the index date. (The index date was the first visit recorded in ISAR with measurements meeting the group eligibility criteria; for biologic users, the index date was the ISAR visit that is closest to the date on first biologic.) Abbreviations: ISAR = International Severe Asthma Registry; LTOCS = Long-term oral corticosteroids Figure 2 . Proportions of patients with severe asthma who experienced ≥2 exacerbations, had uncontrolled asthma and received LTOCS in the 12 months post-biologic initiation.  (The index date was the first visit recorded in ISAR with measurements meeting the group eligibility criteria; for biologic users, the index date was the ISAR visit that is closest to the date on first biologic. For the subgroup of biologic recipients whose asthma remained suboptimally controlled, the index date was the date of the third dose of biologic treatment; among those who switched or stopped biologics, the index date was the ISAR visit closest to the date on first biologic.) Abbreviations: ISAR = International Severe Asthma Registry; LTOCS = Long-term oral corticosteroids The EVEREST study was a historical cohort study of patients enrolled in the International Severe Asthma Registry (ISAR), using data prospectively collected between December 2017 and May 2022. 9587 patients with severe asthma from 21 countries were included. The EVEREST study highlights the substantial challenges experienced by patients who are either denied access to biologics or who, despite being eligible, do not receive these advanced therapies. The research indicates that both groups endure a high disease burden; however, the specific outcomes and healthcare experiences differ significantly between them. Additionally, two-thirds of T2-targeted biologic recipients had a suboptimal response to their prescribed therapies, highlighting the importance of ongoing research and development of more effective therapy options for patients with severe asthma. The EVEREST findings call for collaborative efforts among healthcare providers, policymakers, and researchers to develop strategies that improve and standardize access to biologic therapies, optimize the allocation of resources, and enhance treatment pathways to ultimately reduce the disease burden associated with severe asthma. To learn more about the study, please read the full publication  in the Journal of Asthma and Allergy , as well as the accompanying slide deck .  The EVEREST study was funded by AstraZeneca. The International Severe Asthma Registry (ISAR) is operated by Optimum Patient Care Global Ltd. (OPCG) and co-funded by OPCG and AstraZeneca. To learn more please visit our website: www.isar.opcglobal.org .

A recently published study in Pragmatic and Observational Research , “ Real-world biologic use patterns in severe asthma, 2015–2021: the CLEAR study ”, shows that biologic initiation was associated with improved clinical outcomes compared with non-initiation. Among biologic initiators, switching or stopping biologic therapy was associated with worse clinical outcomes than continuing the initial therapy; however, there remained a need for improvements in outcomes among continuers. These findings call for collaborative efforts among policymakers, clinicians and researchers to increase access to biologic therapies and initiate biologic therapy earlier in eligible patients. As the biologics in this study target immunoglobulin E (omalizumab), interleukin (IL)-4/IL-13 (dupilumab) or IL-5 signalling (mepolizumab, reslizumab or benralizumab), ongoing research on how to predict patient response to these biologics is needed to inform clinical decision-making on selecting the ‘right’ initial biologic for the ‘right’ patient, to reduce the need for switching or stopping. Additionally, further research on new biologic therapies (e.g., the anti-thymic stromal lymphopoietin biologic tezepelumab) that have less restrictive eligibility criteria would be of value. Biologic initiators had fewer exacerbations, were less likely to have uncontrolled asthma and had a greater reduction in daily long-term oral corticosteroid (LTOCS) dose than non-initiators during the follow-up period. Approximately 54.1% of initiators and 66.5% of non-initiators experienced ≥1 exacerbations (annualized count; Figure 1A); 35.6% of initiators and 41.0% of non-initiators had uncontrolled asthma at last assessment (Figure 1B). Initiators had a greater reduction in daily LTOCS dose than non-initiators (adjusted β: −2.73 mg [95% CI: −4.77, −0.68]). Figure 1. Exacerbations (A) and asthma control (B) during the follow-up period among biologic initiators and non-initiators after IPTW. Outcomes were assessed at follow-up (after biologic initiation for initiators) using the closest available data to 12 months after the index date. The index date was the date of biologic initiation for initiators and ISAR enrolment for non-initiators. Abbreviations: IPTW = Inverse probability of treatment weighting; ISAR = International Severe Asthma Registry After biologic initiation, continuers had fewer exacerbations, were less likely to have uncontrolled asthma and had a greater reduction in daily LTOCS dose than switchers or stoppers at follow-up. The proportion of patients who experienced ≥1 exacerbations was 52.7% for continuers, 84.0% for switchers and 61.4% for stoppers (Figure 2A). The proportion of patients with uncontrolled asthma at last assessment was 33.3% for continuers, 67.1% for switchers and 50.1% for stoppers (Figure 2B). The reduction in daily LTOCS dose was smaller for switchers and stoppers than for continuers (adjusted β: 3.77 mg [95% CI: 1.71, 4.37] and 3.09 mg [95% CI: −0.27, 6.45] for switchers and stoppers, respectively, versus continuers). Nevertheless, it should be noted that among continuers, >50% had ≥1 exacerbation (Figure 2A) and one-third had uncontrolled asthma (Figure 2B). Figure 2. Exacerbations (A) and asthma control (B) during the follow-up period among biologic continuers, switchers and stoppers after IPTW. Outcomes were assessed at follow-up (after biologic initiation for initiators) using the closest available data to 12 months after the index date. The index date was the date of biologic initiation for initiators and ISAR enrolment for non-initiators. Abbreviations: IPTW = Inverse probability of treatment weighting; ISAR = International Severe Asthma Registry The CLEAR study was a multicentre, observational study of patients enrolled in the International Severe Asthma Registry (ISAR), using data collected between December 2015 and August 2021. 3,404 patients with severe asthma from 23 countries were included. To learn more about the study, please read the full publication   in Pragmatic and Observational Research , as well as the accompanying slide deck . The CLEAR study was funded by AstraZeneca. The International Severe Asthma Registry  (ISAR) is operated by Optimum Patient Care Global Ltd. (OPCG) and co-funded by OPCG and AstraZeneca. To learn more please visit our website: www.isar.opcglobal.org .

Singapore, [10 April 2025] – A large real world evidence study conducted by leading respiratory experts found patients with asthma who received Glucagon-like peptide1 receptor-agonists (GLP1-RAs) had reduced in emergency hospitalisations, antibiotic use and need for respiratory medication compared to a matched patient population.  The study, titled "The real-world impact of Glucagon-like peptide 1 receptor agonists on asthma control in people with high-risk asthma and obesity" shows that as well as the expected increase in weight loss patients with asthma also had improved asthma control.  This research was conducted using a large UK patient database of over 28 million patients and has just been published in this month’s issue of the medical journal Advances in Therapy .  The analysis identified 10,111 GLP1-RA exposed people and 50,555 unexposed controls. The exposed cohort had higher BMI and more uncontrolled asthma measured using two composite measures of asthma outcomes (Risk Domain Asthma Control (RDAC) and Overall Asthma Control (OAC)). Following the prescribing of the weight loss drug the exposed cohort lost more weight and had improved asthma control for both RDAC (Odds ratio 2.11 95% CI 1.90 to 2.36) and OAC (OR 2.10, 95%CI 1.81 to 2.45) scores.  GLP1-RA drugs appear to improve asthma control for people with obesity.    Professor Alan Kaplan, Medical director of LHIN Pulmonary Rehabilitation clinics in Ontario, Canada and the Observational and Pragmatic Research Institute, concluded, "Our findings suggest that GLP1-RAs have benefits on asthma control in people with obesity, and this information should contribute to the discussions around the decision to use these drugs."  Learn More   Read the full publication , ‘The Real-World Impact of Glucagon-Like Peptide 1 Receptor Agonists on Asthma Control in People with High-Risk Asthma and Obesity’, in the April 2025 issue of Advances in Therapy .  This study was funded and conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd.   About OPRI   The Observational and Pragmatic Research Institute (OPRI) is an internationally recognized independent research organization dedicated to providing real-world evidence that supports best practices in chronic disease management in primary care. Learn more at https://www.opri.org.uk/ . For media inquiries and additional information, please contact https://www.opri.org.uk/contact .

Singapore, [8 April 2025] – Groundbreaking research by the Observational and Pragmatic Research Institute (OPRI) has developed innovative models to predict individual patients’ risks of developing common health problems related to oral corticosteroid (OCS) treatment for asthma.    The study applied advanced statistical techniques to analyse longitudinal electronic medical records (EMR) from nearly 250,000 patients in the Optimum Patient Care Research Database (OPCRD) . The resulting models incorporated OCS prescriptions and onset of medical conditions, together with evidence on risk factors for common morbidities associated with OCS exposure, to predict the future risk of OCS adverse outcomes based on a patient’s unique risk factors and projected OCS use (Figure 1).   Figure 1. Risk of post-menopausal osteoporosis   Mean annual OCS prescriptions were categorized as none, low (<2/year), or high (≥2/year). Cox proportional hazard models for a hypothetical patient were input to survival analyses where only OCS prescriptions varied: unchanged (none to none, low to low, high to high); 1 category increase (none to low, low to high); 1 category decrease (high to low, low to none) – with all other variables held constant. Survival estimates were plotted to give the predicted incidence curve.  In these models, the risks of type 2 diabetes, hypertension, pneumonia, osteoporosis and 12 other OCS-related adverse outcomes significantly increased with projected categoric OCS use. For example, hazard ratios for a one-category increment were 1.55 for type 2 diabetes, 1.56 for post-menopausal osteoporosis, 1.05 for hypertension, and 1.67 for pneumonia (all p < 0.001).    “These real-world, data-driven insights empower clinicians to make informed decisions about reducing OCS use where possible, tailoring treatment to mitigate health risks for individual patients,”  said lead investigator Dr Brooklyn Stanley.    This first tool to assess individualised risk for multiple steroid-related conditions, offers clinicians a new decision-making aid that can be integrated with routine consultations to proactively identify patients at increased risk for future OCS-related morbidities, so that timely interventions can be initiated and OCS exposure minimized, consistent with current best practice in asthma management.    “This study clearly demonstrates the utility of EMR data for predictive analysis,”  said OPRI Director Professor David Price, “these new algorithms can be used to develop a web-based risk calculator that is compatible with EMRs and quality improvement tools internationally.”     Importantly, these real-world primary care EMR data showed that, once started, OCS prescription usually continued long-term; this highlights the unmet need to minimise OCS use, for example, by initiating steroid-sparing or biologic therapies earlier in the asthma treatment pathway. Although barriers such as cost and accessibility remain, this study underscores the potential benefit of shifting from OCS overuse toward precision asthma medicines.    "This research is another important step toward precision medicine in asthma care and underscores the importance of adopting steroid-sparing treatment options,”  said Soram Patel, AstraZeneca Senior Global Medical Affairs Leader.  “ By helping clinicians assess individual patient risks, we can significantly reduce avoidable long-term health risks associated with over-reliance on OCS."     Learn More   Read the full publication , ‘Predicting Risk of Morbidities Associated with Oral Corticosteroid Prescription for Asthma’, in the March 2025 issue of Pragmatic and Observational Research.   This research project was partly funded by AstraZeneca and the Observational and Pragmatic Research Institute.    About OPRI   The Observational and Pragmatic Research Institute (OPRI) is an internationally recognized independent research organization dedicated to providing real-world evidence that supports best practices in chronic disease management in primary care. Learn more at https://www.opri.org.uk/ . For media inquiries and additional information, please contact https://www.opri.org.uk/contact .

A new real-world research study from ISAR, the International Severe Asthma Registry , reveals the strength of the asthma tests (biomarkers) BEC (Blood Eosinophil Count) and FeNO (Fractional exhaled Nitric Oxide) in predicting which severe asthma patients will benefit the most from treatment with biologics, driving critical progress in delivery of targeted, precision medicine in asthma care. The study, published in Frontiers in Immunology   and entitled “ Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma " utilises data across 23 countries and 3,751 patients. Crucially, the results indicated BEC and FeNO levels were strongly linked to the magnitude of lung function improvement following commencement of biologic therapy (specifically anti-IL5/5R [Anti-Interleukin 5/5R] or anti-IgE, [Anti-Immunoglobulin E]). Patients with the highest baseline (prior to biologic treatment) levels of the biomarkers achieved average improvements of 200 mL in the lung function result FEV1 (Forced Expiratory volume in one second), compared to patients with the lowest levels who achieved less than a third of the average improvement in FEV1 (Figure 1). Figure 1 : Association between improvement in lung function and highest pre-biologic Blood Eosinophil Count. Anti IgE: Anti-Immunoglobulin E, Anti-IL-5/5R: Anti-Interleukin 5/5R, Anti-IL4Rα: Anti-Interleukin 4α, BEC: Blood Eosinophil Count, FEV1: Forced Expiratory volume in one second.   In addition, the findings highlight a clear link between improvement in asthma symptoms and BEC for patients receiving the biologic therapy anti-IL5/5R. Following the treatment, the likelihood of having uncontrolled asthma symptoms among those with high BEC levels was almost half that of those with low pre-biologic BEC. Notably, pre-biologic biomarkers were not found to be strongly linked to extent of reduction specifically to asthma attacks before and after biologic treatment, with most patients having clear improvements in asthma attack frequency with biologic therapy regardless of drug type or biomarker levels. Professor David Price, a lead researcher and corresponding author, comments “Our study advances understanding of the associations between biomarkers and asthma outcomes, offering results which can be harnessed as tools in selection of the most effective treatments for individual patients, and driving positive change in asthma care”. Conducting the study through ISAR offered a unique opportunity to study the connections between biomarkers and asthma outcomes following biologic therapy in a large group of severe asthma patients in real-world practice. Patients in the study had a high burden of disease prior to commencing biologics, with almost 70% having uncontrolled asthma symptoms, underscoring the urgency for change. This study brings to light new possibilities in targeting of asthma therapy and, moreover, emphasises the potential for earlier intervention and prevention of lung function decline in asthma patients.   To learn more about the study, please read the full publication  in Frontiers in Immunology, as well as the accompanying slide deck . About ISAR The International Severe Asthma Registry is a global collaborative initiative to gather anonymous, longitudinal, real-life data for patients with severe asthma. ISAR offers a rich source of real-life data for scientific research to understand and improve symptoms, treatments, and patient outcomes for severe asthma. To learn more please visit our website: www.isar.opcglobal.org .

The International Severe Asthma Registry  is a global collaborative initiative to gather anonymous, longitudinal, real-life data for patients with severe asthma. ISAR offers a rich source of real-life data for scientific research to understand and improve symptoms, treatments, and patient outcomes for severe asthma. The latest breakthrough research from the ISAR, as detailed in the recent publication in Chest , has unveiled an interesting landscape of variability in severe asthma exacerbation rates across diverse countries. Led by a diverse team of researchers, including Dr. Tae Yoon Lee and senior authors Prof. Wenjia Chen and Prof. Mohsen Sadatsafavi, this multinational study meticulously analysed data from biologic-naïve patients across 17 countries participating in ISAR, with a specific focus on asthma exacerbation rates and their inherent between-country variations. The findings showed that individuals sharing similar patient characteristics, yet coming from different countries, had greatly varied rates of severe exacerbation. ranging between 0.04 in Argentina to 0.88 in Saudi Arabia (interquartile range: 0.13–0.54). Remarkably, these variations persist even after rigorous adjustments for patient- and disease characteristics and sampling variability (interquartile range: 0.16–0.39). These findings highlight the presence of unidentified patient-specific factors and/or systemic intricacies contributing to the observed variations. It is imperative that disease management guidelines acknowledge and address such between-country variability. To optimize treatment strategies effectively, there is a pressing need for the development of risk prediction models calibrated specifically for each jurisdiction. To learn more about the study, please read the full paper in Chest , as well as the accompanying slide deck . Acknowledgement: This research project is supported by the Ministry of Education, Singapore, under the Academic Research Fund Tier 1 (FY2022—2025).

Singapore, [19 April 2024] – Analysis of data from the Optimum Patient Care Research Database (OPCRD) has shown high rates of systemic glucocorticoid (SGC) prescription for asthma in the United Kingdom (UK), which have persisted despite the availability of alternative steroid-sparing strategies and treatments.   The study, Trends in Systemic Glucocorticoid Utilization in the United Kingdom from 1990 to 2019: A Population-Based, Serial Cross-Sectional Analysis , was conducted by the Observational and Pragmatic Research Institute (OPRI), co-funded by AstraZeneca, and is published in the March issue of Pragmatic and Observational Research . (1) Relative contribution of conditions of interest (a)  to total SGC dose per year Abbreviations: COPD, chronic obstructive pulmonary disease; SGC, systemic glucocorticoid; SLE, systemic lupus erythematosus. (a) Other category includes: ankylosing spondylitis, myasthenia gravis, sarcoidosis, uveitis, autoimmune bullous, eczema, nephrotic syndrome, scleritis, vasculitis, autoimmune hepatitis, gout, polymyalgia, Sjogren’s syndrome, Bell’s palsy, iritis, psoriasis, carditis, multiple sclerosis, psoriatic arthropy, and temporal arteritis.   “These are concerning findings”, said Professor David Price, corresponding author, and Director of OPRI. “The numbers of patients with asthma and COPD in the UK are increasing and any SGC exposure, even occasional short-term use, increases patients’ risk of diabetes, osteoporosis, cardiovascular diseases and other health conditions – even death.”   The OPCRD holds electronic medical records from >20 million patients from >1000 UK general practices. For each year from 1990 to 2019, OPRI researchers determined SGC exposure among patients aged 5 years and above who had asthma, COPD, nasal polyps, Crohn’s disease, rheumatoid arthritis, ulcerative colitis, or systemic lupus erythematosus. Asthma was consistently the greatest contributor to SGC utilization; asthma and COPD accounted for more than two-thirds of UK patients prescribed SGCs every year since 1990. The data showed declines in SGC prescriptions for Crohn’s disease, ulcerative colitis, and rheumatoid arthritis since the introduction of biologic therapies, as well as for severe asthma; however, SGC prescriptions for non-severe asthma and for COPD increased. The relative contribution of COPD to the OCS burden approximately doubled over time, while no biologic therapies for COPD were approved during the observation period.   “These results highlight urgent needs to raise awareness about the adverse consequences of SGC use and to adopt alternative steroid-sparing strategies and treatments that can reduce this largely avoidable burden”, said Professor Price.   To learn more about the study, please read the full publication  in the Pragmatic and Observational Research as well as the accompanying slide deck below. The Observational and Pragmatic Research Institute (OPRI) is an independent, internationally recognised research organisation which conducts studies that provide real-world evidence to support best practices for chronic disease management in primary care and make a difference to patients. https://www.opri.org.uk/   For media inquiries and additional information, please contact https://www.opri.org.uk/contact   Reference (1) Menzies-Gow AN, Tran TN, Stanley B, Carter VA, Smolen JS, Bourdin A, Fitzgerald JM, Raine T, Chapaneri J, Emmanuel B, Jackson DJ, Price DB. Trends in Systemic Glucocorticoid Utilization in the United Kingdom from 1990 to 2019: A Population-Based, Serial Cross-Sectional Analysis. Pragmat Obs Res . 2024;15:53-64. https://doi.org/10.2147/POR.S442959

The new publication ‘The association between short-acting β2-agonist over-prescription, and patient-reported acquisition and use on asthma control and exacerbations: data from Australia’  to Advances in Therapy  from OPCRDA ( Optimum Patient Care Research Database Australia ) delivers a wakeup call about the dangers of blue reliever inhaler (Short-Acting β2-Agonists, SABA) overuse in asthma. In this critical paper, data from 720 patients was utilised in a study design that combines both General Practice (GP) Medical Records and patient questionnaires. It examines the usage of blue reliever inhaler use, and relationship with asthma outcomes in Australia. Major findings are uncovered: Patients using three or more blue reliever inhalers had more than twice as many severe asthma attacks and four times more likely to have major asthma symptoms This was even worse in those only buying reliever inhalers at a pharmacy, with 3 times more asthma attacks and almost 5 times more major asthma symptoms Professor David B. Price , the lead author and Head of the Observational and Pragmatic Research Institute, emphasized, “Our study identifies a critical association between short acting beta agonist overuse and increased risks of adverse outcomes in asthma patients. In light of the magnitude of increased asthma attacks impacting patients, the findings must urge us to engage in careful consideration and monitoring of SABA use in the management of asthma." With availability of the inhalers over the counter being compounded by automated repeat release of prescriptions without medical review, easy access to blue reliever inhalers may be contributing to the concerning problem of their overuse. ‘‘ The findings highlight opportunity to drive positive change in asthma care in Australia”, remarks Professor Christine Jenkins , second author of the study, Professor of Respiratory Medicine UNSW, and Head of Respiratory Group at the George Institute for Global Health, Australia. Professor Jenkins adds “The work calls for reformation of approaches to SABA use in asthma, through enhanced patient and clinician awareness of the impact of its overuse, and by addressing systems in place which may contribute to over acquisition”. Dr Kerry Hancock , co-author of the study and General Practitioner in Australia, also shares “ The study underscores the importance of implementing The Australian Asthma Handbook (AAH) recommendations: replacement of stand-alone SABA with regular low-dose inhaled corticosteroids (ICS) plus as needed SABA, or as needed ICS/formoterol  [inhaled steroids with a long-acting beta agonist medication] 1 ” . While blue reliever inhaler overuse is likely a symptom of poor asthma control rather than its cause, the results stress the importance of urgent medical review for patients affected, in addition to wider evaluation of access to inhalers without medical supervision. To learn more about the study, please read the full publication  in Advances in Therapy, as well as the accompanying slide deck . This study was part of the SABA Use IN Asthma (SABINA) programme, an innovative framework of harmonised, large-scale observational studies across 40 countries, and was co-funded by AstraZeneca. 1. National Asthma Council. Australian Asthma Handbook Version 2.2 [Internet]. 13th ed. 2022, Available from: https://www.asthmahandbook.org.au/ About OPC Optimum Patient Care (OPC) is a social enterprise that provides free clinically led quality improvement programmes into GP practices and respiratory specialists to take part in research. More information about OPC can be found at www.optimumpatientcare.org.au . About OPCRDA Optimum Patient Care Research Database Australia (OPCRDA) has been purposefully designed to facilitate real-world data collection and address the growing demand for observational and pragmatic medical research, both within Australia and internationally. https://www.optimumpatientcare.org.au/contact

ISAR ’s new publication "Association between T2-related co-morbidities and effectiveness of biologics in severe asthma” to  the highly esteemed American Journal of Respiratory and Critical Care Medicine (AJRCCM) brings to light the power of biologics to improve critical outcomes for severe asthma patients with T2 comorbidities, particularly chronic rhinosinusitis and nasal polyps. This cohort study utilised data from 21 countries and 1765 patients with and without allergic rhinitis (AR), chronic rhinosinusitis +/- nasal polyps (CRS+/-NP), NP, or eczema/atopic dermatitis (AD) who have been initiated on anti–IL-5/5R, anti-IgE, or anti–IL-4/13 therapies. Pre and post biologic change was quantified through four high impact asthma outcomes: annual asthma exacerbation rate, % predicted FEV1, asthma control, and long-term oral corticosteroid daily dose.  While commencing biologics led to improvements in all four asthma outcomes irrespective of comorbidity status, crucially, patients with comorbid CRS+/-NP experienced 23% fewer exacerbations per year and had 59% higher odds of better post-biologic control than those without CRS+/-NP; with similar estimates for those with comorbid NP, independent of biomarker profile. Notably, findings for AR and AD conversely were not predictive of treatment effect. These results underline the importance of systematic evaluation for comorbidities and call for multidisciplinary collaboration to facilitate the best possible outcomes in severe asthma care. To learn more about the study, please read the full publication  in the American Journal of Respiratory and Critical Care Medicine (AJRCCM), as well as the accompanying slide deck . .

Observational and Pragmatic Research International Limited is delighted to announce that it has signed up to the Good Business Charter (GBC) , an accreditation that seeks to raise the bar on business practices for employees, tax, the environment, customers and suppliers. The Good Business Charter exists for all UK companies, charities and public sector organisations across all industries and sectors. At a time when people are caring more about who they work for and who they buy from, the GBC offers a straightforward accreditation, recognising organisations that prioritise and value their employees, customers, suppliers and the environment, whilst also paying their taxes according to the spirit of the law. It has never been more important for businesses to build trust and show that they care about more than just profit. Therefore, the GBC and its members seek to inspire many other businesses to follow suit. Chairman of the GBC Board, Simon Fox, said: “The Good Business Charter brings together 10 standards, most of which already exist, but in separate places. We have brought them together to give a coherent overall position for businesses to aspire to. We believe that the GBC has enormous potential to change business practice for good.” Professor David Price, Founder of Observational and Pragmatic Research International, said: "We are delighted to have joined the GBC, which alongside our commitment to Good Clinical Practice for research delivery, we also demonstrate our commitment to work with others in showing how much we value our customers, colleagues, suppliers and the environment.” -Ends- Notes for Editors About Observational and Pragmatic Research International Limited (OPRI) OPRI is an independent research organisation distinguished in accessing unique global data sources to deliver observational and pragmatic research which drives change in clinical practice around the world. OPRI is underpinned by a research faculty of experienced clinical experts, epidemiologists, data analysts, statisticians, medical writers and medical scientists. OPRI’s services range from understanding the burden of illness to evaluating a product’s safety and effectiveness in clinical practice. OPRI has collaborated with Optimum Patient Care Global and Optimum Patient Care UK to deliver on over 100 research projects and 20 clinical trials. This collaboration enables the delivery of a variety of research services across a broad range of fields, using anonymised datasets contributed from Optimum Patient Care Research Database (OPCRD, https://www.opcrd.optimumpatientcare.org/ ) to deliver a research study from protocol development, through to analysis and publication. Our publications can be found here ( https://www.opcrd.optimumpatientcare.org/publications ). This collaboration has been operating for more than 20 years and provide wraparound services to support clinical quality improvement and conduct data driven clinical research, especially pragmatic trials, validation studies, implementation studies, retrospective database studies and post authorisation safety studies. Contact: Victoria Carter Research and Operations Director| victoria@opri.sg | 01223 967855 Website: https://www.opri.org.uk/ About the Good Business Charter The Good Business Charter was developed, and is overseen by, the Good Business Foundation, an independent charity established in 2019 by entrepreneur Julian Richer. The Charter is a simple accreditation which organisations in the UK can sign up to in recognition of responsible business practices. It measures behaviour over ten components (nine for charities and public sector): real living wage; fairer hours and contracts; employee well-being; employee representation; equality, diversity and inclusion; environmental responsibility; paying fair tax; commitment to customers; ethical sourcing, and prompt payment. An organisation must meet all ten components (nine for charities and public sector) to receive GBC accreditation. It is open to private sector, public sector and charities of all sizes including a streamlined version for organisations with 50 employees or fewer. The Good Business Charter is an initiative of the Good Business Foundation, charity number 1186547, company number 12278437. Contact: Jenny Herrera, CEO | jherrera@goodbusinesscharter.com | 07703 453826 Website: www.goodbusinesscharter.com

Important progress has been gained in the journey towards understanding response to biologic therapy in severe asthma through the International Severe Asthma Registry (ISAR) study “Impact of pre-biologic impairment on meeting domain-specific biologic responder definitions in patients with severe asthma (BEAM)” , published in Annals of Allergy, Asthma, & Immunology  and delivered in collaboration with respiratory experts and AstraZeneca. A team of researchers from across the globe including Dr. Luis Perez-de-Llano and corresponding author Prof. David Price from University of Aberdeen evaluated change in asthma outcomes for patients commenced on biologic medications, from treatment initiation to one year following treatment. The study utilizes data across 22 countries participating in ISAR and focuses on change to rates of asthma attacks, asthma control, long-term oral steroid medication use, and lung function. While significant improvements in asthma outcomes following biologic treatment were evident for all categories studied, importantly, the results highlighted that those with a greater severity of disease before treatment showed the greatest magnitude of response. Of patients who experienced for example a high number of asthma attacks (six or more per year) prior to treatment with biologics; 90% improved with treatment, compared to 70% for those with low numbers of asthma attacks per year (one annually).   These results bring light to the powerful change in asthma outcomes possible upon commencement of biologics, particularly to those with great need: patients with high disease severity. Through harnessing of these crucial results, the study brings us one step closer to accurate prediction of response to biologic treatment in asthma. To learn more about the study, please read the full publication  in Annals of Allergy, Asthma, & Immunology, as well as the accompanying slide deck .   About ISAR The International Severe Asthma Registry is a global collaborative initiative to gather anonymous, longitudinal, real-life data for patients with severe asthma. ISAR offers a rich source of real-life data for scientific research to understand and improve symptoms, treatments, and patient outcomes for severe asthma.