Biologic therapy improves life quality of asthmatic children

Treatment with biologic agents results in significant improvements in both function and quality of life among paediatric patients with moderate-to-severe asthma, according to a recent study presented at ACAAI 2023.

However, such improvements do not extend to a reduction in healthcare utilization. Some differences in efficacy have also been observed between the agents.

“There is limited data about the effectiveness of biologics on asthma within the paediatric population,” said the researchers, led by Dr William Tredwell from Norfolk, Virginia, US. “The aim of this study is to characterize the outcomes of paediatric patients receiving biologic therapy.”

Tredwell and his team carried out a retrospective chart review to collect data from patients, including spirometry (FEV1), quality of life (ACT) measures, number of emergency department (ED) visits/urgent care visits/hospitalization, asthma exacerbations, and systemic corticosteroid use, between 12 months before and after the start of therapy.

The biologic agents assessed in this study were omalizumab, mepolizumab, and dupilumab. Finally, the research team used the SPSS.26 software for the two-sided statistical analysis.

A total of 115 paediatric patients with moderate-to-severe asthma were enrolled in this study. Significant improvements from baseline were observed in ACT scores and FEV1 measures at 12 months after treatment. [ACAAI 2023, abstract A022]

At 6 months after initiation of biologic therapy, substantial decreases were noted in asthma exacerbations (p<0.001), ED visits (p<0.001), and systemic corticosteroid use (p<0.001). On the other hand, there was no marked difference seen in the number of urgent care visits (p>0.05) or hospitalizations over time (p>0.05).

In comparisons of each biologic therapy, similar results were observed in all measures except in FEV1 and ACT scores. Specifically, only omalizumab displayed a significant difference in FEV1 between baseline and 12 months after therapy (p=0.010), while mepolizumab (p=0.91) and dupilumab (p=0.63) did not. Moreover, both omalizumab (p<0.001) and mepolizumab (p=0.016) demonstrated significantly lower ACT scores from baseline to 12 months post-treatment, but dupilumab did not (p=0.37).

“Improvements are seen in paediatric patients in both functional and quality of life asthma measures after receiving biologic therapies,” according to the researchers.

These findings were consistent with those of an earlier study, which reported improved quality of life and reduced ED visits and asthma exacerbations within 1 year of starting therapy among children with moderate-to-severe asthma. [Ann Allergy Asthma Immunol 2022;doi:10.1016/j.anai.2022.08.644]

In this 2022 study, 54 paediatric patients were included, of whom 85 percent had a diagnosis of severe asthma. Quality of life measures increased over 12 months after start of therapy (moderate asthma: p=0.024; severe asthma: p<0.001). Spirometry measures showed no significant change. Additionally, asthma exacerbations (p=0.002) and ED visits (p=0.003) significantly decreased post-treatment.

Notably, 10 of the 54 paediatric patients with moderate-to-severe asthma discontinued treatment. Of these, six failed to show response to therapy and one had an adverse reaction.