Abstract Rationale Asthma is a chronic airway disease characterized by chronic inflammation with airway hyperresponsiveness and airflow limitation. Biologics have allowed for greater asthma control, improved patient morbidity and quality of life. Methods We performed a retrospective chart review for patients receiving mepolizumab, benralizumab, or dupilumab for uncontrolled asthma ≥1 year between 2019-2024 in University Hospital Galway, Ireland. We examined the number of asthma exacerbations (as identified by number of high dose oral corticosteroid OCS courses used), lung function (FEV1% predicted value), Asthma Control Test (ACT) score, and hospital utilization rates in the year pre- and post-commencement of biologic therapy. Super-responders were exacerbation-free and off maintenance OCS at one year, partial-responders were those with ≥50% reduction in exacerbations or ≥ 50% reduction in maintenance OCS at one year, and non-responders discontinued anti-IL5 treatment or did not fulfil response category. Patient characteristics recorded included history of atopy, highest eosinophil count prior to biologic initiation, comorbidities such as nasal polyps or reflux disease, and if they were transferred from an alternative biologic and why. Results A total of 77 patients were included. Mean age 55 years old (S.D 15 years). 28 patients were commenced on mepolizumab (36%), 47 benralizumab (61%), and 2 dupilumab (3%). Asthma exacerbation rates decreased by 75% in year following biologic initiation (mean 5+3 OCS pre-biologic, 1+2 OCS post-biologic; p 0.01). 73 patients had ACT scores pre and post-biologic initiation with a mean ACT score improvement of 35% which reached the minimal important difference of 3 (mean ACT score pre 15+5, mean ACT post 20+4). There was an increase of 13% in FEV1 post biologic initiation (mean FEV1% pre 75+18 pre, 85+21 post; p 0.01). Hospital utilization also declined; total asthma-related hospital admissions decreased by 37.5% (16 pre, 10 post), and total inpatient hospital days decreased by 47% (106 pre, 56 post). 22 patients (29%) were classified as super-responders, 30 patients (39%) as partial responders, and 25 patients (32%) as non-responders. Conclusion In this real-world cohort, biologic therapy for severe asthma was associated with a 75% reduction in exacerbation rates, improved asthma control and lung function, and reduced hospital utilization. These findings support the effectiveness of biologic agents in optimizing asthma outcomes and reducing disease burden in clinical practice. Non-responders should be continuously assessed and changed to alternative biologic therapies as appropriate. This abstract is funded by: None
Kerins et al. (Fri,) studied this question.