Ethnic Minorities Found More Likely to Require Change in Biologic Therapy for Severe Asthma

New research presented at the 2024 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting, February 23-26, 2024, in Washington, DC, sheds light on real-world patterns of biologic use in a diverse patient population with severe asthma.

“Biologic therapies have revolutionized the management of severe asthma. However, response to therapies is not well understood in ethnic minorities,” wrote presenting author Rubabin Tooba, MD, and fellow colleagues from Baylor College of Medicine in Houston, Texas.

Tooba and coauthors conducted the observational study to analyze the characteristics and patterns of biologic use among patients with severe asthma who were treated at a county hospital in Houston, according to the abstract.

Researchers reviewed electronic medical records of patients with a diagnosis of severe asthma and current/former biologic use. They retrieved data on comorbidities, demographics, medications, pulmonary function tests, lab values, Asthma Control Test scores, and exacerbation frequency.

“Data were expressed as continuous (mean ± standard deviation) and categorical variables. Analyses were conducted with chi-square and unpaired t-test,” wrote Tooba et al.

FINDINGS

A total of 69 participants (mean age, 57 years) were included in the study, of whom 30 (43%) were Hispanic and 23 (33%) were Black, according to the abstract.

Researchers found that 18 (26%) participants required a change in prescribed biologic therapy. Participants in this subgroup were more likely to be Black (P = .004) and be using omalizumab (P = .011), and less likely to be using dupilumab (P = .039).

Also, participants that required a switch in their biologic therapy had poorer asthma control at 3 months (P = .045) and 6 months (P = .003) after initiation of biologic therapy and showed a trend towards an allergic phenotype at baseline (P = .057), according to investigators.

“While biologics may be advantageous in severe asthma, response to and switch in therapy are not well-understood in ethnic minority populations. Our results suggest that in this high-risk population, racial background, initial therapy type, asthma control, and allergic phenotype may be significant indicators,” concluded researchers.

Source: Tooba R, Pathak A, Bilal M, Hanania N, Adrish M. Real-life patterns of biologic use and switch for severe asthma at a major county hospital. J Allergy Clin Immunol. 2024;153:AB101. doi:10.1016/j.jaci.2023.11.331