The following is a summary of “Factors Associated With Asthma Biologic Prescribing and Primary Adherence Among Adults in a Large Health System,” published in the June 2023 issue of Allergy and Clinical Immunology: In Practice by Gleeson et al.

The availability of asthma biologics may be of equal benefit to some patients. The researchers sought to identify patient characteristics associated with biologic prescribing, primary adherence, and efficacy for asthma. A retrospective, observational cohort study of 9,147 adults with asthma who established care with a Penn Medicine asthma subspecialist between January 1, 2016, and October 31, 2021, was conducted using Electronic Health Record data. Factors associated with receiving a new biologic prescription, primary adherence, defined as receiving a dose in the year after receiving the prescription, and oral corticosteroid (OCS) surges in the year after receiving the prescription were identified using multivariable regression models. 

Factors associated with a new prescription received by 335 patients included being female (odds ratio [OR] 0.66; P =.002), currently smoking (OR 0.50; P =.04), having an asthma hospitalization in the previous year (OR 2.91; P<.001), and having 4+ OCS bursts in the last year (OR 3.01; P<.001). Reduced primary adherence was associated with Black race (incidence rate ratio 0.85; P<.001) and Medicaid insurance (incidence rate ratio 0.86; P .001), although most patients in these groups, 77.6% and 74.3%, still took their medication. In 72.2% of cases, nonadherence was associated with patient-level barriers, and in 22.2% of cases, with health insurance denial. 

After receiving a biologic prescription, more OCS surges were associated with Medicaid insurance (odds ratio = 2.69; P =.047) and biologic days covered (odds ratio = 0.32 for 300–364 days vs. 14–56 days; P =.03). Asthma biologics’ primary adherence in an extensive health system varied by race and insurance type, whereas patient-level barriers predominantly explained non-adherence.

Source: sciencedirect.com/science/article/abs/pii/S2213219823002830