Advanced Management Strategies in Severe Asthma and COPD (MC)-Switching Biologics in Asthma Khurana

Switching Biologics in Asthma Khurana

Pdf Summary

The document, titled "Master Class: Advanced Management Strategies in Severe Asthma and COPD," presented by Dr. Sandhya Khurana, explores the complexities of switching biologics in asthma treatment. The primary focus is on understanding why and how biologics are switched, emphasizing the lack of substantial evidence supporting these decisions.<br /><br />Dr. Khurana outlines the factors determining a "good" clinical response in asthma patients, which include reduced oral corticosteroid (OCS) exposure, fewer exacerbations, improved ACT/ACQ/AIRQ scores, and improved lung function. Observational studies such as those by Menzies-Gow et al. highlight real-world patterns and reasons for biologic switching. Common reasons include insufficient clinical efficacy, adverse effects, and accessibility issues. Data suggest that 10-11% of patients either stopped or switched biologics, indicating potential under-switching of biologics initially prescribed.<br /><br />Several studies, such as the OSMO study and others, demonstrated improved outcomes (e.g., reductions in exacerbation rates) following biologic switching. Notably, specific biomarker changes, like FeNO levels, and increased healthcare utilization were associated with patients who switched biologics. Treatment failures can be attributed to incorrect endotype identification, inadequate dosing, or other confounding factors such as non-adherence.<br /><br />Overall, the key takeaway from Dr. Khurana is that switching biologics can improve asthma outcomes substantially. Observational evidence indicates that up to 25% of asthma patients switch biologics due to suboptimal responses or adverse effects. Success in switching relies on closely monitoring patient responses at 3-6 months post-treatment initiation and adjusting treatment plans based on biomarkers, comorbidities, and patient preferences. The session argues for a strategic approach to biologic switching in severe asthma management.<br /><br />The session concludes with a post-test question regarding the outcomes of switching to dupilumab from other biologics, underscoring the importance of personalized treatment strategies in severe asthma.

Keywords

asthma

COPD

Chronic Obstructive Pulmonary Disease

biologics

Dr. Sandhya Khurana

treatment switching

clinical response

observational studies

biomarkers

personalized treatment

severe asthma management

COPD

Chronic Obstructive Pulmonary Disease