The following is a summary of “Perceived waning of biologics in severe asthma,” published in the NOVEMBER 2023 issue of Pulmonology by Kroes, et al.

In treating severe asthma, biologic drugs are known for their significant effectiveness and are typically administered at fixed intervals. However, in clinical practice, some patients perceive a diminishing biologic effect before their next scheduled dose, raising questions about the prevalence and clinical relevance of this phenomenon. For a study, researchers sought to investigate the perceived waning effect of biologics before the next administration, examining its frequency, severity, associated symptoms, and relationship with patients’ clinical characteristics.

Patients with severe asthma who had been receiving biologic treatment for at least four months were included in the study. A questionnaire focusing on the waning effect of biologics was developed based on insights gained from 17 semi-structured patient interviews. The questionnaire was then distributed to 129 patients, and clinical data, including asthma control (ACQ) and quality of life (AQLQ) scores, were collected from patient records.

Out of the 101 patients who completed the questionnaire, 65 reported experiencing a perceived waning effect of biologics before their next scheduled dose, characterizing its severity as high, with a median score of 6.5 on a 0-10 BORG scale. These patients reported a wide range of symptoms associated with the waning effect. Those who perceived the effect had higher ACQ scores and lower AQLQ scores compared to those who did not (P < 0.05). Furthermore, higher BORG scores were linked to a higher frequency of asthma exacerbations (ρ = 0.309, P = 0.013). Notably, about one-third of the patients expressed a preference for either extending or shortening their dosing interval.

The study revealed that a substantial portion of patients with severe asthma perceived a reduction in the biologic effect before their next scheduled dose. The phenomenon was associated with poorer asthma control and reduced quality of life. The diversity in reported symptoms suggested the potential for individualized dosing strategies for biologic medications.

Source: resmedjournal.com/article/S0954-6111(23)00304-9/fulltext