Abstract

Phenotype-guided biological therapy in patients with severe asthma has supposed a significant upgrade in their management. The aim of this study is to determine if the initiation of biological therapy spares cumulative corticosteroid dose (by any cause), as to describe the clinical outcomes associated with the response.

A retrospective observational study was performed in patients with severe asthma which start Phenotype-guided biological therapy (Anti-IgE, Anti-IL5, Anti-IL5R) between January 2018 and August 2021. Demographic data, asthma-associated variables, comorbidities and maintenance treatment were registered. Furthermore, the response-associated clinical variables at baseline, 6-month and 12-month follow-up were registered: exacerbations, asthma control test (ACT), daily oral-corticosteroid mean dose, annualized cumulative corticosteroid dose (by any cause) and function lung test (FEV1).

A total of 44 patients were included, with a median age of 60±10 years and 59% of women. Demographic and baseline data distribution is shown at Table 1. Biological therapy effectiveness at 6-month and 12-month follow-up is shown at Table 2.

A significative cumulative corticosteroid dose reduction is observed, changing from 2,204 g of prednisone at baseline to 1,077 g at 6-month follow-up (p=0,0001) and to 0,492 g at 12-month follow-up (p=0,0001). Moreover, an improvement of the other asthma-control clinical variables is appreciated.

In conclusion, phenotype-guided biological therapy initiation significantly decreases cumulative corticosteroid dose and decreases daily maintenance oral-corticosteroid mean dose, as well reduce number of exacerbations and improves the symptomatic control.