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What happens when people stop asthma biologics?

Published online: July 1, 2021

Most of the research studying asthma biologics is focused on what happens when people start treatment. Less attention has been devoted to what happens when asthma biologics are stopped. There are 2 clinical trials that tested what happens when asthma biologics are stopped. The sample sizes for these studies were small, and the differences in asthma attacks between groups were also small.

Jeffery and colleagues reported new information about stopping asthma biologics in The Journal of Allergy and Clinical Immunology: In Practice. They identified people with asthma who stopped treatment in a large database of people from the US and matched each of these people to a similar person in the database who did not stop their asthma biologic. They then compared outcomes. They selected similar people using a method called propensity matching, which means that the patients in each group were very similar in age, sex, race, region, insurance coverage, annual income, access to specialists, number and type of other medical problems, and their baseline asthma severity.

From a group of about 5,000 people who used asthma biologics, the authors found about 1,000 people who stopped use after at least 6-12 months of continuous use. They then found another 1,000 people with similar characteristics who continued their asthma biologics as a comparison group. They found that 10.2% of people experienced an increase in asthma attacks after stopping asthma biologics, compared to 9.5% of people who continued. The statistical analysis suggested that the odds of asthma exacerbations were similar if people stopped or continued. The investigators found similar results when they limited the outcome to only the most severe asthma attacks. The authors concluded that people who stop asthma biologics do not necessarily experience an increased risk of  asthma attacks.  

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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