Quality of Life Improvements with Biologic Initiation Among Subspecialist-Treated US Patients with Severe Asthma

Purpose: Patients living with severe asthma (SA) experience multiple health-related quality of life (HRQoL) impairments. This study examined HRQoL changes after biologic treatment initiation among a large, real-world cohort of patients with SA. Patients and methods: CHRONICLE is an ongoing observational study of subspecialist-treated adults with SA who receive biologics or maintenance systemic corticosteroids or are uncontrolled on high-dosage inhaled corticosteroids with additional controllers. Patients enrolled February 2018–February 2023 were asked to complete the St. George's Respiratory Questionnaire (SGRQ) every 6 months (total score range of 0– 100 0=best possible health, meaningful change threshold is a 4-unit reduction in the total score). Changes in SGRQ responses from 6 months before initiation to 12 to 18 months after initiation were summarized. Results: A total of 76 patients completed the SGRQ 0 to 6 months before and 12 to 18 months after biologic initiation. The mean (SD) SGRQ total score decreased from 52.2 (20.6) to 41.9 (23.8), with improvement across the symptoms (− 14.5), activity (− 11.0), and impacts (− 8.3) components. For specific impairments reported by ≥ 50% of patients before biologic initiation, fewer reported each impairment after biologic initiation; the largest reductions were for "Questions about what activities usually make you feel short of breath these days Walking outside on level ground" (67% to 43%), "Questions about other effects that your respiratory problems may have on you these days I feel that I am not in control of my respiratory problems" (55% to 34%), and "Questions about your cough and shortness of breath these days My coughing or breathing disturbs my sleep" (63% to 45%). Conclusion: In this real-world cohort of adults with SA, biologic initiation was associated with meaningful improvements in asthma-related HRQoL. These data provide further insight into the burden SA places on patients and the benefits of biologic treatment. Keywords: observational, real-world, health-related quality of life, St. George's Respiratory Questionnaire