Page 63 - Škrgat, Sabina, ed. 2023. Severe Asthma Forum - Monitoring and Treatable Traits in Severe Asthma. Koper: University of Primorska Press. Severe Asthma Forum, 2
P. 63
Monitoring and Evaluation 3.2
of Therapeutic Response in Patients
with Severe Asthma on Biologics
Sanda Škrinjarić Cincar1,2
Abstract 1 School of Medicine Osijek
Five biologics with different mechanisms of action have been available for uncontrolled severe University J.J. Strossmayer
T2 high asthma in clinical practice worldwide for years, and the first drug in a class of new b i-
ologics targeting the top of the inflammatory cascades, thymic stromal lymphopoietin (TSLP) 2 Health Center Osijek
is available from the beginning 2022. The results of randomized and real-life studies as well as
experience in daily clinical practice confirm that the safety profile of biological drugs is very
good. Biologics have a good potential to achieve remission during treatment, but not all pa-
tients respond equally well. The effectiveness of all b iologics in severe asthma is approximate-
ly 60% in the real life conditions. An important task of the clinician is the correct assessment
of the therapeutic response to biologics and the evaluation of patients who have a satisfactory
response to treatment and those who do not. Therapeutic response to biologics should be as-
sessed individually according to pre-defined goals every 3 to 6 months. In patients with a good
response to biological drugs, continuation of treatment and continuous monitoring of efficacy
and safety is recommended. If there is no satisfactory response to the initially introduced bio-
logic, switching to another biologic is a rational option. During therapy with biologics, it is nec-
essary to closely monitor the effect on exacerbations and symptoms. Research has shown that
improving the overall quality of life is the most important outcome for most patients with se-
vere asthma. Also, one of the most important effects of biological therapy is the possibility of
excluding or reducing the dose of corticosteroids in patients who need them for disease control.
The effect of b iologics on improving lung function is important, but not critical for evaluat-
ing the effectiveness of treatment. However, previous reports have not yet provided precise in-
structions for long-term treatment with biologics in daily clinical practice, and there are ques-
tions still need to be answered.
Keywords: severe asthma, b iologics, therapeutic response, evaluation
Introduction: a new treatment options tibodies has made it possible to attack cer-
for uncontrolled severe asthma tain pathogenic pathways or mechanisms and
modifies them in order to control disease. In
Severe asthma is a disabling disease that ac- recent years the treatment of severe asthma
counts for not more than 5% of all asthmat- with biological drugs in selected patients with
ics1. Although patients with severe asthma T2-high inflammation has become very suc-
represent a minority of the total asthma pop-
ulation, they carry a majority of the morbid- cessful. The development of biological drugs
ity and healthcare costs. Accurate treatment for T2-low asthma was not so successful3.
with biologics in the form of monoclonal an-
https://doi.org/10.26 493/978 -961-293 -297-8.63 -75
of Therapeutic Response in Patients
with Severe Asthma on Biologics
Sanda Škrinjarić Cincar1,2
Abstract 1 School of Medicine Osijek
Five biologics with different mechanisms of action have been available for uncontrolled severe University J.J. Strossmayer
T2 high asthma in clinical practice worldwide for years, and the first drug in a class of new b i-
ologics targeting the top of the inflammatory cascades, thymic stromal lymphopoietin (TSLP) 2 Health Center Osijek
is available from the beginning 2022. The results of randomized and real-life studies as well as
experience in daily clinical practice confirm that the safety profile of biological drugs is very
good. Biologics have a good potential to achieve remission during treatment, but not all pa-
tients respond equally well. The effectiveness of all b iologics in severe asthma is approximate-
ly 60% in the real life conditions. An important task of the clinician is the correct assessment
of the therapeutic response to biologics and the evaluation of patients who have a satisfactory
response to treatment and those who do not. Therapeutic response to biologics should be as-
sessed individually according to pre-defined goals every 3 to 6 months. In patients with a good
response to biological drugs, continuation of treatment and continuous monitoring of efficacy
and safety is recommended. If there is no satisfactory response to the initially introduced bio-
logic, switching to another biologic is a rational option. During therapy with biologics, it is nec-
essary to closely monitor the effect on exacerbations and symptoms. Research has shown that
improving the overall quality of life is the most important outcome for most patients with se-
vere asthma. Also, one of the most important effects of biological therapy is the possibility of
excluding or reducing the dose of corticosteroids in patients who need them for disease control.
The effect of b iologics on improving lung function is important, but not critical for evaluat-
ing the effectiveness of treatment. However, previous reports have not yet provided precise in-
structions for long-term treatment with biologics in daily clinical practice, and there are ques-
tions still need to be answered.
Keywords: severe asthma, b iologics, therapeutic response, evaluation
Introduction: a new treatment options tibodies has made it possible to attack cer-
for uncontrolled severe asthma tain pathogenic pathways or mechanisms and
modifies them in order to control disease. In
Severe asthma is a disabling disease that ac- recent years the treatment of severe asthma
counts for not more than 5% of all asthmat- with biological drugs in selected patients with
ics1. Although patients with severe asthma T2-high inflammation has become very suc-
represent a minority of the total asthma pop-
ulation, they carry a majority of the morbid- cessful. The development of biological drugs
ity and healthcare costs. Accurate treatment for T2-low asthma was not so successful3.
with biologics in the form of monoclonal an-
https://doi.org/10.26 493/978 -961-293 -297-8.63 -75
