Real world adherence to biologic therapy for severe asthma in children.

IF 6.6 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-09-23 DOI:10.1016/j.jaip.2025.09.020

Steven J Rose, Aisaku Nakamura, Md Monir Hossain, Theresa W Guilbert, Rachelle R Ramsey

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引用次数: 0

Abstract

Background: Biologic medications improve asthma symptoms, spirometry, and exacerbation rates in patients with severe asthma. However, little is known about adherence to biologic medications in children.

Objectives: To describe adherence to biologic medications in pediatric asthma and evaluate cofactors and outcomes related to adherence.

Methods: A retrospective chart review was performed of patients at a single medical center with severe asthma to calculate adherence during the first year on biologic therapy. The relationship of adherence with method of administration (i.e. home nursing, clinic, or independent), medication dosing frequency, and insurance was examined using multiple regression models. The effect of biologic therapy on asthma outcomes was analyzed using generalized linear regression models.

Results: Patients demonstrated 84% adherence to biologic therapies during the first 6 months of therapy (SD = 19, n=186) and 76% over 12 months (SD = 23, n=155). Method of administration, insurance type, and dosing frequency impacted adherence. Outcomes improved on biologic therapy such that asthma exacerbations decreased by 0.8 (SD=1.9) exacerbations per year, FVC z score improved by 0.26 (SD=0.7), and FEV1 z score improved by 0.3 (SD = 0.8). Decreased exacerbations rates and increased FVC and FEV1 were associated with adherence to therapy over the first 12 months.

Conclusions: Patients with severe asthma demonstrated higher rates of adherence to asthma biologic medications than has been demonstrated for inhaled corticosteroids. Biologic therapies were associated with decreased asthma exacerbations and improved spirometry, and these changes were associated with adherence. Medication administration strategy, insurance type, and dosing frequency impacted adherence.

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现实世界中对儿童严重哮喘生物治疗的依从性。

背景：生物药物可改善严重哮喘患者的哮喘症状、肺活量测定和加重率。然而，关于儿童对生物药物的依从性知之甚少。目的：描述儿童哮喘患者对生物药物的依从性，并评估与依从性相关的辅助因素和结果。方法：对在单一医疗中心的重症哮喘患者进行回顾性图表回顾，以计算第一年生物治疗的依从性。使用多元回归模型检验依从性与给药方式（即家庭护理、诊所或独立用药）、给药频率和保险的关系。采用广义线性回归模型分析生物治疗对哮喘预后的影响。结果：在治疗的前6个月，84%的患者（SD = 19, n=186）和76%的患者（SD = 23, n=155）坚持使用生物疗法。给药方法、保险类型和给药频率影响依从性。生物治疗的结果得到改善，哮喘发作次数每年减少0.8次（SD=1.9）次，FVC z评分改善0.26次（SD=0.7）， FEV1 z评分改善0.3次（SD= 0.8）。在最初的12个月里，恶化率降低、FVC和FEV1增加与坚持治疗有关。结论：重度哮喘患者对哮喘生物药物的依从性高于吸入皮质类固醇。生物疗法与减少哮喘加重和改善肺活量有关，这些变化与依从性有关。药物管理策略、保险类型和给药频率影响依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.