Biologics in severe eosinophilic asthma treatment: four years of a single-centre follow-up

<bold>Introduction:</bold> The real-life data of biologic treatment effects are crucial for choosing an adequate and effective severe asthma therapy. <bold>Aims and objectives:</bold> We aimed to evaluate the effects of biologics in severe eosinophilic asthma patients from our center. <bold>Methods:</bold> The research included 41 patients treated with biologics between March 2020 and February 2024. Data were analyzed for the peripheral blood eosinophil count before and 24 hours after the first dose of anti-IL5 therapy, and FEV1%, Fractional Exhaled Nitric Oxide (FeNO), and Asthma Control Test (ACT) score initially, and after 6, 12 and 24 months of treatment. <bold>Results:</bold> In the examined group, 35 patients (85.4%) received benralizumab with an average of 8.6±4.4 (1-20) doses. Peripheral blood eosinophil count was significantly reduced 24 hours after the first dose (580.9±350.7 vs. 55.8±71). From this group, 19 patients (54.3%) received 11.7±3.3 doses, resulting in a significantly increased FEV1% (57.7±14.32 vs. 73.8±29.5) and ACT score (10.5±5 vs. 19.9±4) after 6 months of therapy. These effects are also maintained after 12 months of therapy (FEV1%: 73.9±33.8; ACT score: 21±3.6). Seven patients (20%) were treated for 24 months maintaining increased FEV1% (47.4±13.6 vs. 56.4±33.8) and ACT score (8.8±2.5 vs. 19.5±3.7), compared to initial values. FeNO test was unavailable at treatment initiation, but there is a significant decrease in values measured after 12 and 24 months of therapy (85±75.9 vs. 56±58.1 ppb). <bold>Conclusion:</bold> We conclude that benralizumab therapy in patients with severe eosinophilic asthma results in decreased eosinophilic airway inflammation, leading to significant and stable improvement of lung function and disease control.