Real World Using Dual biological therapy in severe asthma: Insights from Four Cases

IntroductionAsthma is a chronic and heterogeneous disease. However, some severe asthma cases remain uncontrolled despite biologic monotherapy. Dual treatment with biologics may be beneficial in such cases, especially those who exhibit features of allergic and eosinophilic inflammation simultaneously.Case StudyWe describe four patients with severe asthma who only partially improved with one biologic. Based on persistent symptoms and biomarker analysis, a second biologic directed against a different inflammatory pathway was added as part of their treatment protocol.ResultsFollowing dual biologic therapy, all the four patients showed significant improvement in Asthma Control Test (ACT) scores, reduction in exacerbations (from a median of 9 to 0.5/year), and reduced oral corticosteroid (OCS) usage (median 9 to 0.5/year). FEV1 remained stable or improved. No significant adverse effects were noted during 12 months of follow-up.ConclusionThis case series demonstrates that dual biologic therapy is an effective and safe treatment option in a carefully selected subgroup of patients with severe uncontrolled asthma.