Background

Understanding of treatment response to biologic therapy for severe asthma in the real world remains limited.

Objective

To examine multiple levels of response to biologic therapy in adults with severe asthma in ISAR.

Methods

This multi-country (n=23), registry-based study included patients ?18 years who initiated biologics (anti-IL5/5R, anti-IgE, anti-IL4/IL13). Response in the 12 months (min. 6 months) post-initiation among impaired patients (as defined in Figure 1) was assessed as: ?50% reduction in exacerbation rate, ?50% reduction in LTOCS daily dose, ?1 level improvement in asthma control, and ?100 mL increase in FEV1, alone or in combination of 2,3, 4 endpoints.

Results

Of total 1986 eligible adults, median age was 54 years, 59.7% were female; 79.7%, 53.6%, 47.4%, and 53.1% of patients achieved response in exacerbation, LTOCS, asthma control, and FEV1, respectively. Treatment response ranged from 43.6% to 10.5% when extending the definition from 2 to 4 endpoints. Greater response was observed in patients treated with anti-IL5/5R and anti-IL4/IL13 (Figure 1).

Conclusion

Biologic effectiveness is evidenced as a large proportion of patients achieved response in at least one endpoint. There is still unmet need as the majority were non-responders in composite 4 endpoints. Response varies by definition, thus, multiple endpoints should be considered to fully assess response to biologics.