Minimizing Steroid Burden in Severe Asthma: Real-World Data Demonstrate Biologics as a Game Changer
- puiyeelai
- Jun 3
- 3 min read
Drawing on data from over 5,600 severe asthma patients across real-world specialist and primary care settings in 22 countries, the SOLAR I study led by Drs. David Price and Wenjia Chen, “Impact of biologic initiation on oral corticosteroid use in the International Severe Asthma Registry and the Optimum Patient Care Research Database: a pooled analysis of real-world data”, was recently published in JACI: In Practice. The study showed that biologic initiation delivered substantial reductions in oral corticosteroid (OCS) use, a key challenge in severe asthma management due to the risks of cumulative steroid exposure.
The SOLAR I study found that compared to non-biologic-initiators, patients with severe asthma who initiated biologics experienced earlier and substantially greater total OCS reductions, with more than twice the likelihood of reducing OCS daily dose by >75%, or complete cessation, in the first year (Figures 1 and 2). A jackknife sensitivity analysis further strengthened the robustness of the results, by showing consistent biologic initiation-associated OCS reductions across 23 settings in 22 unique countries. These findings highlight the need for rigorous, personalized OCS tapering strategies in real-world settings, and early biologic intervention with rigorous first-year monitoring.
Following on from SOLAR I, the SOLAR II study showed that biologic initiators had 18% lower risk of developing any OCS-related adverse outcome compared to non-initiators, primarily driven by the reduced risk of developing diabetes (by 38%), major cardiovascular event (by 35%), and anxiety/depression (by 32%) (Sadatsafavi M et al. Am J Respir Crit Care Med 2025). The findings of SOLAR I and II highlight the value of biologic therapy in minimizing steroid burden and preventing OCS-related adverse outcomes in patients with severe asthma.
Read the full article of the SOLAR I study in JACI: In Practice (Full Publication / Slide Deck).
Read the full article of the SOLAR II study in Am J Respir Crit Care Med (Full Publication / Slide Deck).
Acknowledgement: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was funded by AstraZeneca Ltd with in-kind contribution from Optimum Patient Care Global (OPCG). The study uses data from the International Severe Asthma Registry (ISAR), which is co-funded by OPCG and AstraZeneca.
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.
About ISAR
The International Severe Asthma Registry (ISAR) is the first global adult severe asthma registry, providing a rich, standardized dataset to advance research, clinical practice, and policy in severe asthma care. Since its establishment in 2017, ISAR has recruited >34,000 patients from 30 countries, and undertaken 26 research projects with 30 publications and 63 abstracts. ISAR fosters international collaboration to improve outcomes for patients worldwide. It is operated by Optimum Patient Care Global Ltd. (OPCG) and co-funded by OPCG and AstraZeneca. Learn more at https://www.isar.opcglobal.org.
About OPCRD
The Optimum Patient Care Research Database (OPCRD) is a high-quality, longitudinal primary care database containing the electronic health records of >25 million patients from >1000 general practices across the UK. It facilitates real-world collection of patient-level diagnostic, clinical and prescribing information. Its data has been used in 100 studies, with the achievement of 121 publications. OCPRD collaborates with other databases and registries (including ISAR) on asthma research. Learn more at https://opcrd.optimumpatientcare.org.
