Relationship between knowledge, adherence and self-management with response to monoclonal antibody therapy in patients with severe asthma

<bold>Background:</bold> Severe asthma presents a significant burden on patient quality of life and healthcare systems worldwide. While the response to monoclonal antibody (mAb) therapy is known to be influenced by several factors, the interplay between disease-specific knowledge, patient adherence and self-management remains poorly characterized in asthmatic patients with mAb treatment. <bold>Methods:</bold> In this multicentre, cross-sectional study asthma-specific knowledge was evaluated by a self-developed questionnaire comprising 55 yes/no questions with one point awarded for each correct answer. Adherence was assessed using the A14-questionaire and patients’ self-management and activation by PAM-13-questionaire. Response to mAb therapy was determined using the Biologics Asthma Response Score (BARS). <bold>Results:</bold> This study included 145 patients undergoing mAb therapy (87 responders, 35 partial-responders, 23 non-responders) from three German severe asthma outpatient clinics. Responders showed a slightly higher asthma knowledge than non-responders (mean score 45.2 vs. 44.7 vs. 42.7, p=0.045). Additionally, PAM-13 scores (mean 45.2 vs. 44.5 vs. 43 points, p=0.200) resulted in no differences between groups while A14-scores (mean score 50 vs. 51 vs. 47 points, p=0.018) exhibited statistically significant distinctions. Logistic regression analysis indicated a significant effect of knowledge (OR 1.11, p=0.009) and adherence (OR 1.12, p=0.024) on mAb treatment response but not for self-management. <bold>Conclusion:</bold> Our study emphasizes the importance of patient education and adherence monitoring in optimizing outcomes for severe asthma patients undergoing mAb therapy.