Suboptimal response to biologics in severe asthma with antibody deficiencies

Published: March 26, 2024

Asthmatic patients with antibody deficiencies have more severe disease and a higher risk of exacerbations. Biologics are currently used as add-on therapy in patients with uncontrolled severe asthma, despite standard-of-care treatment. No data exists about the efficacy of biologics in severe asthma patients with antibody deficiencies.

A case-control real-life study, published in The Journal of Allergy and Clinical Immunology: In Practice, was performed by Tiotiu et al. to evaluate comparatively the efficacy of biologics in severe asthma patients with and without antibody deficiencies. Sixty-eight patients were included and divided into two equal groups: group 1 with severe asthma and antibody deficiencies and group 2 with severe asthma.

Treatment by biologics for 6 months was effective in decreasing the number of exacerbations, hospitalizations, and emergency department visits, in improving symptoms control score, and providing a systemic corticosteroid sparing effect in both groups. However, the response to treatment was lower in group 1 with severe asthma and antibody deficiencies than in group 2 with severe asthma in terms of decrease of exacerbation rate, hospitalizations, emergency department visits, improvement of symptoms control and increase of lung function. As such, those patients with severe asthma treated with biologics need more comprehensive follow-up.

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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