OPA2 A NORTHERN MALAYSIAN PERSPECTIVE ON BIOLOGIC THERAPY’S CLINICAL RESPONSE AND REMISSION IN INDIVIDUALS WITH SEVERE ASTHMA

Izzatul Ismail1, Amir Asyraf Mohd Rushdan1, Arvindran Alaga1
1. Respiratory Department, Hospital Sultanah Bahiyah, Kedah

Introduction

Severe asthma affecting 5-10% of asthma patients increases morbidity, mortality and healthcare burden. Biologics is the new effective strategy to treat severe asthma with potential disease remission by targeting specific cytokines in type 2 inflammatory pathway and chosen based on patients’ severe asthma phenotype. 

Objectives

The study aims to identify specific severe asthma phenotypes and assess the clinical response and remission including phenotype change by using biologics in severe asthma treatment. 

Methodology

This is a retrospective observational study which included severe asthma patients in Respiratory Department, Hospital Sultanah Bahiyah from January 2018 until December 2023 initiated on biologics. Clinical response to biologics is monitored via annual asthma exacerbation rates, asthma control test (ACT) score, IgE and eosinophil levels, lung function test and safety profile. 

Results

14 patients were recruited (mean age of 47.2+18.2 years) with 36% allergic asthma, 14% eosinophilic asthma and 50% mixed phenotypes. There is reduction in mean serum IgE levels (1032 to 872) and mean eosinophil levels (840 to 206, p value<0.001) post biologics. Reduction of exacerbation rate as also observed from mean of 30.5+27.7 exacerbations/year to 2.14±3.32 exacerbations/year (p value<0.001) with mean ACT score increment of 11.43+2.95 (p value<0.001). Significant improvement is also noted in mean FEV1 (64.9% to 69.2%) alongside mean FEV1/FVC ratio (73% to 76.8%). 5 patients had a change of asthma phenotype but only 2 patients required change of biologics. In general, we observed that 64% achieved clinical response while 29% achieved clinical remission post biologics with only 2 patients developing minor complications.

Conclusion 

Biologics has tremendous benefit in reducing asthma exacerbations, improving lung function and overall quality of life. It also has significant potential of clinical response and remission which indirectly reduces healthcare burden cost.