Asthma Biologics: Real-World Effectiveness, Impact of Switching Biologics and Predictors of Response

Abstract Background Confirmation of effectiveness of asthma biologics in the real-world is desirable as patient characteristics and experiences may differ from those included in randomized controlled trials. Objective: Evaluate real-world effectiveness of asthma biologics and identify predictors of response. Methods We performed a retrospective study in patients with severe asthma receiving biologics. The primary outcome was change in clinically significant exacerbations at 12 months after starting biologic therapy, compared to 12 months prior. Secondary outcomes were change in severe exacerbations, maintenance oral corticosteroid (OCS) dose, pre-bronchodilator (pre-BD) forced expiratory volume in second 1 (FEV1), and Asthma Control Test (ACT) scores. Sub-group analyses were performed for subjects who were biologic naive or not. A stepwise logistic regression model was performed to compare responders to non-responders. Results 112 patients were included. Biologic therapy was associated with a 59% reduction in clinically significant exacerbations (P 500 cells/uL. Conclusion In a real-world setting, biologic therapy in asthma is effective in improving exacerbations, asthma control and lung function. Patients who demonstrate a suboptimal response to one biologic can still benefit from treatment with a different biologic.