Impact of biological therapies on clinical outcomes in patients with severe eosinophilic asthma with chronic rhinosinusitis: an observational study from Saudi Arabia

Abstract Background We aimed to study the impact of biological therapies in Saudi Arabia on patients with severe asthma (SA) combined with chronic rhinosinusitis (CRS) in terms of clinical outcomes. Methods This is a retrospective observational cohort research that was undertaken at the severe asthma clinics of the Armed Forces Hospital of the Southern Region (AFHSR) and King Khalid University Hospital, Abha, from March to September 2022 to delineate the effects of 3 biological therapies (dupilumab, benralizumab, and omalizumab) in adults with SA and concomitant CRS. Clinical outcomes assessed included asthma exacerbation frequency, hospitalization rates, use of oral corticosteroids (OCs), and the asthma control test (ACT) scores before and 1 year after biological therapies. Results Eighty patients were enrolled, with a mean age of 46.68. There were 45 (56%) females and 35 (44%) males. There was a notifiable decrease in the frequency of exacerbations and hospitalization and in the number of patients who received OCs after 6 and 12 months of biological therapies compared to pre-biological therapies, respectively ( p < 0.001 each), while there was a significant increase in the ACT scores at 6 and 12 months post-biological therapies, compared to pre-biological therapies, respectively ( p < 0.001). These significant differences were maintained with all the 3 biologics used. Conclusions Results from the first study from two large Saudi Arabian tertiary centers for patients with SA and CRS agree with and support those of worldwide real-life ones. One-year follow-up showed the effectiveness of the 3 drugs in terms of reduced frequency of asthma hospitalizations and exacerbations, the use of OCs, and improved ACT scores. Further prospective multicenter studies are warranted.