Biologicals reduce drug burden and improve physical and mental health in severe eosinophilic asthma.

Objective: This real-world study evaluates the improvement in asthma control, drug burden reduction, and physical and mental health in patients with severe eosinophilic asthma treated with biologicals.

Methods: We enrolled 127 patients with severe eosinophilic asthma from two centers, treating them with add-on biological therapy. The asthma control test (ACT) and the Short-form Health Survey-12 (SF-12), including Physical Component Summary (PCS) and Mental Component Summary (MCS), were used, assessing drug history at baseline (T0) and after 32 weeks of biological therapy (T1).

Results: A significant improvement in asthma control was observed after the biological treatment (ACT score: 11(8) vs 23(3), p < 0.0001), with most patients achieving asthma control at T1 (110, 86.6%). There was a statistically significant reduction in the use of non-biological drugs at T1, such as oral corticosteroids (40.2% vs 17.3%, p < 0.0001), inhalation therapy (75.6% vs 57.5%, p = 0.001), leukotriene receptor antagonists (34.6% vs 25.2%, p < 0.0001), and antihistamines (42.5% vs 18.1%, p < 0.0001). ACT and PCS scores at T1 had a strong positive correlation (r = 0.749, p < 0.0001), as did ACT and MCS scores (r = 0.744, p < 0.0001). Our study shows that the biological treatments for severe eosinophilic asthma, properly characterized through a careful phenotypic assessment, significantly improve asthma control and reduce drug burden (notably oral corticosteroids, inhalation therapy, leukotriene receptor antagonists, and antihistamines), as well as enhance both physical and mental health irrespective of age and sex.