Choosing and switching biologics for patients with severe asthma – real life data from the German Asthma Net

Severe asthma is defined as asthma which requires maximal inhaled corticosteroid dose and an additional medication or oral corticosteroids to remain controlled or is uncontrolled despite this treatment. Over the last two decades six biologics have progressively become available to treat severe asthma. Even if current guidelines do support respiratory physicians in the choice of biologic therapy, there are knowledge gaps in understanding real life practice and its effect on improving asthma control, especially since the arrival of the last biologic, tezepelumab, available in Germany since 2022.

We aim to describe how patient characteristics differ depending on whether the initial biologic therapy is anti-IgE, anti-IL5/anti-IL5 receptor, anti-IL4R or anti-thymic stromal lymphopoietin (TSLP) directed, using the German Asthma Net (GAN) registry. In addition, we will analyse prescription practice over time, also depending on the availability of the respective biologics, and frequency, timing and type of switches to a different biologic therapy whenever occurring. Finally, we will describe the change in asthma control parameters (symptom control, exacerbations, lung function) and type 2 inflammation markers (blood eosinophils, exhaled nitric oxyde) depending on the switch constellation. Statistical analyses will include paired tests for each switch configuration as well as regression analyses where applicable.

Our results are expected for the start of 2025 and shall add to the growing database of exact phenotyping of patients with severe asthma in order to better tailor their biologic therapy and its possible switch if the initial response remains insufficient.

Publication History

Article published online:
18 March 2025