Prevalence of Patients with Uncontrolled Asthma Despite NVL/GINA Step 4/5 Treatment in Germany.

Asthma is one of the most prevalent chronic diseases in Germany affecting 4-5% of all adults and 10% of children. Despite the availability of biologicals in recent years, studies show patients with inadequately controlled severe asthma in real life. The aim of the current study was to characterize and estimate the number of patients with NVL/GINA level 4 or 5 asthma and signs of poor control in Germany. In 2021, we retrospectively analyzed data collected during 2019 using the IQVIA™ LRx and IQVIA™ Disease Analyzer databases which contain anonymized longitudinal data covering approximately 80% of statutory health insurance (GKV) prescriptions in Germany with most relevant information about prescriptions, basic patient demographics or location of the prescriber; the IQVIA™ Disease Analyzer anonymized electronic medical records from a representative sample of office-based GPs and specialists. An expert committee of pulmonologists from different hospitals and expert practices supported the study. Asthma patients treated according to NVL/GINA 4/5 who used SABAs frequently (≥3 on days with no ICS-containing prescriptions/year) and/or received prescriptions for oral corticosteroids (OCS) (score of ≥2/year, a pulmonologist prescription scored 1.0, GP 0.75) were classified as severe, uncontrolled asthma. In 2019, 3.4 million patients received at least two prescriptions of respiratory medications and 2.4 million patients on maintenance respiratory treatment have asthma. A total of 625,000 asthma patients were treated according to NVL/GINA step 4 or 5. Among these, 54,000 were uncontrolled according to the pre-defined OCS and/or SABA use, which corresponds to approximately 15% of patients in certain regions. In 2019, approximately 54,000 patients in Germany treated according to NVL/GINA step 4/5 had evidence suggestive for poor asthma control, up to 15% of patients in certain regions. Yet, only 12,000 patients overall were being treated with biologicals suggesting a possible treatment gap that requires further investigation.

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© 2022 Bergmann et al.

Déclaration de conflit d'intérêts

KCB and OS have no relevant competing interests to disclose. SH is a GSK employee and shareholder. KM reports speaker and/ or advisory fees from AstraZeneca, GSK, Novartis, Sanofi. CN received honoraria and advisory board fees from GSK, Sanofi, AstraZeneca and Novartis. DS received honoraria for lectures and/or consultancy from AstraZeneca, Bayer, Berlin-Chemie, Boehringer, Chiesi, GSK, Janssen, Novartis, Pfizer. RL is an employee of IQVIA. IQVIA is a technology service provider that carried out the database studies within the scope of a commercial engagement with GSK. DK reports personal fees from GSK. JCV has lectured for and received honoraria from AstraZeneca, Avontec, Bayer, Bencard, Bionorica, Boehringer-Ingelheim, Chiesi, Essex/Schering-Plough, GSK, Janssen-Cilag, Leti, MEDA, Merck, MSD, Mundipharma, Novartis, Nycomed/Altana, Pfizer, Revotar, Sandoz-Hexal, Stallergens, TEVA, UCB/Schwarz-Pharma, Zydus/Cadila and has participated in advisory boards for Avontec, Boehringer-Ingelheim, Chiesi, Essex/Schering-Plough, GSK, Janssen-Cilag, MEDA, MSD, Mundipharma, Novartis, Regeneron, Revotar, Roche, Sanofi-Aventis, Sandoz-Hexal, TEVA, UCB/Schwarz-Pharma and has received research grants from Deutsche Forschungsgesellschaft, Land Mecklenburg-Vorpommern, GSK, MSD and is a full time employee of the Universitätsmedizin Rostock. The authors report no other conflicts of interest in this work.