Achieving control of severe asthma with targeted therapy

Abstract

The purpose of the study was to assess the clinical and functional parameters of patients with severe asthma to optimize drug therapy in order to improve the control. Methods. We examined 45 patients diagnosed with severe asthma: 34 (75%) women and 11 (25%) men. The median age was 56 (30; 70) years. 37 (82%) respondents had an allergic asthma phenotype, while 8 (18%) patients had non-allergic asthma. As for the comorbidities, allergic rhinitis was the most common (56%), intolerance to NSAIDs was observed in a third of the studied patients, and chronic polypous rhinosinusitis (CPRS) was diagnosed in 20 (44%) patients. Results. Each respondent was diagnosed with at least 1 marker of T2 immune response. Before the initiation of biologics, the patients experienced frequent asthma attacks daily, and a high need for SABA was determined. None of the patients had asthma symptoms under control. After 4 months, the control indicator, AST test score, improved to 22 [20; 25] points. The low FEV1 of 65.5% (48.6; 76.8) and FEV1/FVC of 61.4% (43.9; 72.1) before the initiation of biological therapy should be noted. However, the pulmonary function parameters improved after 4 months – the FEV1 increased to 82% (51.0; 93.4), and FEV1/FVC raised to 71.3% (51.2; 74.4). Conclusion. All patients were diagnosed with at least 1 marker of T2 immune response. Thus, the correct selection of patients with T2 immune response markers makes it possible to prescribe personalized drug therapy, which, in turn, ensures the achievement of control over asthma. After 4 months biological therapy, the patients noted the absence of exacerbations, a decrease in the need for SABA, and an improvement in pulmonary function.