Shifting Trends in Severe Asthma Biologics: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 12, 2025, we reported on findings from 2 studies presented at the 2025 American Academy of Allergy, Asthma, & Immunology and World Allergy Organization, February 28 – March 3, 2025 in San Diego, CA.

The studies

The first study, CHRONICLE, is an ongoing real-world observational analysis of adults with severe asthma (SA). Participants have received biologics, systemic corticosteroids, or other systemic immunosuppressants for at least half of the previous 12 months or have SA this is uncontrolled despite receiving high-dose inhaled corticosteroids with additional controllers. For participants enrolled between February 2018 and February 2024, clinicians at participating sites reported medication use every 6 months beginning 12 months before enrollment. Researchers summarized initiation of biologic therapy both descriptively overall and for each site by each half-year (1H: January–June, 2H: July–December).

The second study analyzed USOptum Market Clarity data (2007 to 2023) for adults with a diagnosis of asthma within 12 months of the first administration of 1 of 6 approved biologic drugs and at least 12 months of follow-up. Use of the 6 agents among the final cohort of 10 088 was: omalizumab (n = 5048), dupilumab (n = 2096), mepolizumab (n = 1545), benralizumab (n = 1301), reslizumab (n = 84), and tezepelumab (n = 14).

The findings

CHRONICLE: Among 4037 enrolled patients, 65% (n = 2612) received biologic therapy. Between the second half of 2018 (2H-2018) and 2H-2023, initiation rates declined for benralizumab (42% to 16%), mepolizumab (21% to 9%), omalizumab (26% to 7%), and reslizumab (3% to 1%). The use of dupilumab increased from 8% to 39%, and tezepelumab rose from 0% to 29% over the same period. By 2H-2022 through 2H-2023, initiation rates for dupilumab (34%) and tezepelumab (33%) were nearly identical, signaling their growing dominance in severe asthma management.

USOptum Market Clarity Analysis: Overall adherence was low, with approximately 20% of participants receiving only the initial dose and an average medication possession ratio (MPR) across all 6 biologics ranging from 21.9% to 41.1%. Among the 7,931 patients receiving 1 or more follow-up dose, MPR increased to between 30.1% and 50.3%.

Authors' comments

"Insights from these findings may guide personalized interventions to improve long-term asthma management."

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