Biologic Persistence in Asthmatics

A Korean woman is at a medical consultation. She has asthma and her doctor is holding a puffer. The patient is listening intently as the doctor explains how to use the device correctly. The two are seated at a table together.

It is recommended that patients with asthma take biologics consistently for at least four months to determine their efficacy. However, persistent biologic use among asthmatics in clinical practice is not widely understood. A study published as part of the AAAAI Annual Meeting assessed biologic persistence in asthmatics.

Data spanning 2003 through 2018 were collected from the OptumLabs Data Warehouse (including patients with commercial and Medicaid insurance) on patients with asthma who used at least one asthma biologic. Asthma exacerbations were defined as having an asthma diagnosis correlated with a visit to the emergency department or hospitalization or filling a systemic corticosteroid prescription.

A total of 7,977 patients used asthma biologics, and 4,659 (58%) had complete 12-month data. Of those with complete data, about two-thirds (n=3,123; 67%) had at least six months of biologic persistence. Of the six-month persistence group, 640 (20%) experienced at least a 50% reduction in asthma exacerbations over the first six months of use compared with the six months prior. Of the 2,483 patients who did not experience a six-month 50% reduction in asthma exacerbations, two-thirds (n=1,640) took the asthma biologic for at least 12 more months.

“Some patients fail to complete a six-month treatment period with an asthma biologic. Many patients continue an asthma biologic for 12 months or more without having a 50% or greater reduction in asthma exacerbations during first six months of treatment. Optimal use of asthma biologics should include attention to persistence of use and the timing of discontinuation,” the study authors recommended.

https://www.jacionline.org/article/S0091-6749(19)31906-2/fulltext