Beneficios de la terapia biológica en asma grave: un registro multicéntrico chileno

Abstract

Introduction: Severe asthma is defined by the need for high-intensity treatments, or systemic corticosteroids (OCS) for at least 50% of the time in the last year. Biological therapy has been shown to reduce exacerbations, improve symptoms, and reduce OCS use. In some patients it would achieve remission of the disease. To date there are no publications regarding the Chilean experience with these drugs. Our objectives were: (1) To evaluate the response to one year of biological therapy in severe asthma compared to the previous year; (2) Provide national data on patients treated with biologic the­rapy, in terms of the rate of exacerbations and hospitalizations, the need for OCS, the impact on FEV1 and symptoms control compared to the previous year. Patients and Materials: Chilean multicenter study. Demographic, clinical and therapeutic variables were recorded, in addition to exacerbations and hospitalizations. Pretreatment data were compared with results after one year of biologic adminis­tration. Results: 74 patients, of which 70.3% were women, with an average age of 53.27 ± 13.8 years. Predominant phenotype was eosinophilic-allergic (63.5%). After one year of treatment with biological agents, a significant reduction in annual exacerbations was observed from 3.14 per patient to 0.4 per patient. Annual hospitalizations were significantly reduced. OCS dependency decreased from 52.3% to 35.4% (p = 0.07). Pre-bronchodilator FEV1 increased by a median of 370 ml (p < 0.01), and there was improvement in symptoms control through ACT, with an increase of 11 points (median after one year of therapy 20 points). Conclusions: This first Chilean multicenter report confirms the benefits of biological therapy demonstrated in foreign clinical studies, with a decrease in exacerbations and hospitalizations as well as an improvement in FEV1 and symptoms control.