Background: In real-life studies and RCTs, biologic treatment has shown reduction in daily oral corticosteroid (OCS) use in eosinophilic asthma patients with observational periods up to 2 years. Here, we present real-life data on OCS sparing effects of biologic treatment after 5 years of treatment.

Method: We performed an observational study of severe eosinophilic asthma patients who were treated with mepolizumab, benralizumab, reslizumab or dupilumab. Switching between the drugs were allowed. Data on OCS and biologics were collected before initiation of biologics and after 1, 2 and 5 years from electronic patient records.

Result: 78 patients with severe eosinophilic asthma were treated with biologics for five years. 78% of these patients were on daily OCS before initiating biologic treatment. After 1, 2 and 5 years of biologic treatment the percentage of patients with daily OCS use were reduced to 50, 29 and 17% respectively. The mean daily OCS dose among patients on OCS before initiating biologic treatment was 11.25 mg (CI 10.0-12.5). After 1, 2 and 5 years, the mean OCS dose among patients still on OCS was reduced to 6.7, 5.9 and 5.8 mg (CI 5.2-8.2; 4.0-7.8; 3.6-8.0) respectively. Among the 17% of patients who were still on OCS after 5 years, one patient suffered from ABPA, another patient suffered from adrenal insufficiency and was on low dose OCS treatment. The remaining patients experienced exacerbation of asthma symptoms on further OCS tapering.

Conclusion: Our study shows that biologic treatment effectively reduces the need for daily OCS in patients with severe asthma with a further reduction in the number of patients using daily OCS even after 5 years.