What question did this study set out to answer?

To assess how intermittent and long-term oral corticosteroid use alters biomarker profiles and disease burden in severe asthma prior to biologic initiation.

June 3, 2025World Allergy Organization JournalOpen Access

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR)

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Authors

FSFlorence SchleichUniversity of Liège DLDésirée Larenas‐LinnemannHospital Médica Sur AAAlan AltrajaTartu University Hospital

Discussion

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Implication

Cohort study reveals oral corticosteroids suppress blood eosinophil levels in severe asthma, highlighting risks of biomarker misclassification prior to biologic therapy.

Key Points

To assess how intermittent and long-term oral corticosteroid use alters biomarker profiles and disease burden in severe asthma prior to biologic initiation.
Registry-based cohort study analyzing data collected between 2003 and 2023 across 23 countries from the International Severe Asthma Registry (ISAR) (N=4,305).
Patients were categorized into three cohorts based on oral corticosteroid (OCS) prescriptions in the prior 12 months: no OCS (n=215, 5.0%), intermittent OCS (≤90 days, n=2,330, 54.1%), and long-term OCS (>90 days, n=1,760, 40.9%).
Evaluated blood eosinophil count (BEC), fractional exhaled nitric oxide (FeNO), and total IgE in the year before biologic initiation, assessing clinical phenotypes by BEC cut-off (<150 vs ≥150 cells/μL) in long-term OCS users.
Median BEC was significantly lower in the long-term OCS cohort compared to the intermittent OCS cohort (310 vs 400 cells/μL; p < 0.001).
BEC <150 cells/μL occurred in 28.6% (369/1,288) of long-term OCS users, 19.5% (284/1,460) of intermittent OCS users, and 14.0% (21/150) of non-users, with similar suppression observed for IgE, while FeNO remained largely unaffected.
Among long-term OCS users with BEC <150 cells/μL, 39.9% experienced ≥4 exacerbations, 75.1% had uncontrolled symptoms, and 55.9% had persistent airflow obstruction (compared to 40.9%, 76.2%, and 59.5% in those with BEC ≥150 cells/μL, respectively).

Cite This Study

Schleich et al. (2025) studied this question.

synapsesocial.com/papers/6a97db4df2421ac7db15dd66 https://doi.org/10.1016/j.waojou.2025.101066

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Implication

Cohort study reveals oral corticosteroids suppress blood eosinophil levels in severe asthma, highlighting risks of biomarker misclassification prior to biologic therapy.

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR)

Discussion

Member takes

Implication

Key Points

Cite This Study

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR)

Discussion

Member takes

Implication

Key Points

Cite This Study

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