RETROSPECTIVE REVIEW OF PATIENTS WITH ASTHMA WITHOUT TYPICAL PULMONARY FUNCTION TESTS ON BIOLOGIC THERAPY

Abstract

SESSION TITLE: Allergy and Airway Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Biologic therapy is being increasingly utilized in asthmatic patients including those who have been excluded from clinical trials.(1,2) We sought to evaluate whether severe asthmatics with atypical pulmonary function tests (PFTs) have improved asthma control test (ACT) scores after initiation of biologic therapy. METHODS: A retrospective cohort analysis of patients with asthma on biologic therapy at Thomas Jefferson University Hospital. We excluded those with both FEV1 <80% predicted and bronchodilator response. We assessed patient characteristics, steroid courses, and ACT scores after 2-4 months and 5-7 months. RESULTS: Thirty five out of 103 patients met inclusion criteria. Average BMI was 32.8 kg/m2. Follow up ACT data at 2-4 months was available for 25 patients and 22 patients at 5-7 months. Average ACT score at baseline was 13.9, at 3 months 16.5 and at 6 months 18.5. 71% had poorly controlled asthma at baseline with 64% at three months, and 55% at six months.(3) Additionally one of twenty seven (3.7%) where data available at baseline had zero steroid courses in past year, while at six month ten of twenty three (43%) had not had a steroid course since start of biologic therapy. CONCLUSIONS: Patients with atypical pulmonary function results can have clinically significant improvement in ACT score after initiation of biologic therapy. Additionally they may have reduced steroids courses after biologic therapy. These patients would not have been included in clinical trials used to approve these medications and thus to our knowledge have not been evaluated in this fashion. Prospective randomized trials should be undertaken to better characterize effect of biologic therapy in clinical asthma patients without typical asthma PFTs. CLINICAL IMPLICATIONS: Patients with severe asthma without PFTs typical of clinical trials can be considered for biologic therapy. DISCLOSURES: No relevant relationships by Chandala Chitguppi, source=Web Response No relevant relationships by Alan Gandler, source=Web Response No relevant relationships by Tawfiq Khoury, source=Web Response Scientific Medical Advisor relationship with Astra Zeneca Please note: $1-$1000 Added 05/24/2020 by Jessica Most, source=Web Response, value=Honoraria Active Clinical Trial relationship with Astra Zeneca Please note: $1-$1000 Added 05/24/2020 by Jessica Most, source=Web Response, value=Grant/Research Support Speaker/Speaker's Bureau relationship with Genentech Please note: $1001 - $5000 Added 05/24/2020 by Jessica Most, source=Web Response, value=Honoraria No relevant relationships by Kira Murphy, source=Web Response no disclosure on file for Gurston Nyquist; no disclosure on file for Prachi Patel