Dual Biologic Therapy: Is It Safe?

Patients with more than one allergic/immunologic disease may be treated with multiple biologic therapies at a time. There are limited data on patient outcomes and safety for dual biologic therapies in this patient population. A study published as part of the AAAAI Annual Meeting reported on outcomes for patients who require dual biologic therapy and concluded that this may be a safe practice.

The researchers queried electronic medical records for patients aged older than 18 years who underwent biologic treatment at their allergy, asthma, and immunology specialty clinics at two large urban hospitals, as well as a second biologic for any indication over the last 10 years. The initial biologic had to be one usually used in allergy and immunology practices. The use of the second biologic was classified as either a period of overlap (at least one dose of each biologic within 30 days) or ongoing therapy (simultaneous treatment with both biologics beyond 30 days).

Of 314 total patients treated with a single biologic, 26 (8.3%) received dual biologic therapy (ongoing simultaneous biologic therapy, n=12; period of overlap, n=14). In the ongoing therapy group, nearly all patients (n=11) had a positive clinical response to the initial biologic. No correlation was observed between dual biologic therapy and serum sickness-like reactions, infusion-related or injection site reactions, or any other significant adverse reaction, and there did not appear to be any patient reports of increased immune suppression or frequency of infections.

“This report of patients on dual biologic therapy adds to the literature suggesting that dual biologics may not increase risk or impair clinical response,” the researchers summarized.

https://www.jacionline.org/article/S0091-6749(19)32500-X/fulltext