Abstract
BACKGROUND: Biologic therapies are effective in reducing asthma exacerbations in patients with severe asthma; however, the impact of age and sex on the real-world effectiveness of these therapies is not well understood. OBJECTIVE: Our aim was to examine real-world outcomes before and after biologic initiation among adults with severe asthma, stratified by age and sex. METHODS: CHRONICLE was an observational study of subspecialist-treated US adults with severe asthma. Eligible patients included those receiving maintenance systemic corticosteroids or other systemic immunosuppressants or those patients whose asthma was uncontrolled despite receiving high-dosage inhaled corticosteroids and additional controllers. Asthma exacerbation rates were compared 6 months before and 6 months after biologic initiation in patients stratified by age and sex. To enable a self-controlled analysis, the included patients had no biologic use during the preinitiation period. RESULTS: Of the 800 patients (549 female and 251 male) who started treatment with a biologic and had complete data for at least 6 months before and 6 months after initiation, 294 were aged 18 to 49 years, 314 were aged 50 to 64 years, and 192 were aged 65 years or older. Across the different biologic therapies evaluated, the reductions in exacerbation rate ranged from 37% to 63% among patients aged 18 to 49 years, 44% to 52% in patients aged 50 to 64 years, 56% to 63% among patients aged 65 years or older, 34% to 66% in males, and 46% to 62% in females. CONCLUSION: Biologic therapies reduce asthma exacerbations in adults with severe asthma, regardless of age or sex. These findings support the use of biologics in diverse patient populations.