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

Objective This real-world study evaluates the improvement in asthmacontrol, drug burden reduction, and physical and mental health inpatients with severe eosinophilic asthma treated with biologicals.Methods We enrolled 127 patients with severe eosinophilic asthma fromtwo centers, treating them with add-on biological therapy. The asthmacontrol 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 32weeks of biological therapy (T1). Results A significant improvement inasthma control was observed after the biological treatment (ACT score:11(8) vs 23(3), p < 0.0001), with most patients achieving asthma controlat T1 (110, 86.6\%). There was a statistically significant reduction inthe 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 PCSscores 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 thatthe biological treatments for severe eosinophilic asthma, properlycharacterized through a careful phenotypic assessment, significantlyimprove asthma control and reduce drug burden (notably oralcorticosteroids, inhalation therapy, leukotriene receptor antagonists,and antihistamines), as well as enhance both physical and mental healthirrespective of age and sex.