Initiating Biologics for Severe Asthma Associated With Improvements in Quality of Life

A recent study in the Journal of Asthma and Allergy found that patients with severe asthma experienced “meaningful” improvements in asthma-related health-related quality of life (HRQOL).

The study, part of the ongoing observational CHRONICLE project, focused on a cohort of 76 adults with severe asthma. Between February 2018 and February 2023, patients enrolled in the study were subjected to regular assessments from 6 months before biologic initiation to 12 to 18 months after initiation using the St. George’s Respiratory Questionnaire (SGRQ).

The mean SGRQ total score exhibited a notable decrease from 52.2 at 6 months before initiating biologics to 41.9 at the final assessment. Moreover, improvements were observed across various domains, including symptoms (−14.5), activity limitations (−11.0), and overall impacts of the condition (−8.3).

Before initiating biologic treatment, more than half of participants reported experiencing limitations in various aspects of their daily lives due to asthma-related symptoms. However, following the initiation of biologic therapy, fewer patients reported these impairments. Specifically, SGRQ responses to these 3 questions saw the most improvement:

• “Questions about what activities usually make you feel short of breath these days [Walking outside on level ground]” (67% vs 43%)
• “Questions about other effects that your respiratory problems may have on you these days [I feel that I am not in control of my respiratory problems]” (55% vs 34%)
• “Questions about your cough and shortness of breath these days [My coughing or breathing disturbs my sleep]” (63% vs 45%)

The findings of this real-world study underscore the potential benefits of biologic treatments in alleviating the burden of severe asthma and improving HRQOL for affected individuals. By targeting underlying inflammatory pathways, biologics offer a personalized approach to treatment, addressing the specific needs of patients who have not responded adequately to conventional therapies.

“Shared decision-making has been shown to improve adherence and outcomes such as asthma control and lung function, as well as asthma-related HRQOL, among patients with poorly controlled asthma,” the investigators wrote. They concluded that the findings of their study “may help physicians structure individualized discussions regarding specific aspects of HRQOL and their implications for treatment options” and “underscore the value of biologic treatment” for patients with severe asthma.