Although "biologics have been really revolutionary for the treatment of severe uncontrolled asthma, we still don't have evidence to know the right drug for the right patient," said Wendy Moore, MD, from the Wake Forest School of Medicine in Winston-Salem, North Carolina.
Wendy Moore "You start with your best guess and then switch," she told Medscape Medical News. There are no real-world contemporary measurements of biologic therapy in the United States at this time, Moore explained during her presentation of findings from the CHRONICLE trial at CHEST 2020. The agents have different targets: omalizumab targets immunoglobulin E, mepolizumab and reslizumab target interleukin (IL)-5, benralizumab targets the IL-5 receptor, and dupilumab targets the common receptor IL-4 receptor A for IL-4 and IL-13. |
When the starting biologic doesn't get the desired results, there is no evidence to show whether another will work better. What we say is, "this one is not working as well as I'd like, let's try something new?" said Moore.
However, when looking at data on patients with severe asthma who change from one biologic to another, "I was actually pleased to see that only 10% are switching," she told Medscape Medical News.
But, she added, "if you add that up with the 8% who are stopping, that means that almost 20% don't get the clinical response they want."
