Optimization of biological therapy in severe asthma

<bold>Optimization of biological therapy in severe asthma</bold> <bold>Background:</bold> The biological therapy has revolutionized the treatment of severe asthma, becoming a key component in its treatment, but its high cost to limit use, making it a challenge to choose the biological is the most appropriate for each patient, as well as defining when to suspend, modify or change the therapy. <bold>Objectives:</bold> To describe the results obtained from a biological therapy optimization strategy in patients with severe asthma. <bold>Methods:</bold> Retrospective observational study carried out between April 2019 and December 2023, based on the clinical and economic results obtained in a biological therapy optimization strategy, in patients with severe asthma treated in a specialized outpatient clinic. A univariate analysis was performed, with measures of central tendency, relative and cumulative frequencies. The statistical package R Core Team Version 4.2 was used. <bold>Results:</bold> 154 patients were evaluated with a mean age of 47 years (SD 17), 72.7% were women. Initial biologic treatment was omalizumab in 74%, benralizumab 12.3%, mepolizumab 8.4% and dupilumab 5.2%. According to clinical follow-up, pharmaceutical interventions were performed in a total of 61 patients (39.6%) and the following strategies were implemented to optimize therapy without affecting asthma control in patients: discontinuation of biologic therapy 59%, dose adjustment 16.4% and change of treatment 1.6%. The effect of the intervention was 80% reduction in the crises and hospitalizations and a direct saving of USD $562,000 per year. <bold>Conclusions:</bold> Specialized and interdisciplinary evaluation allows the management of biologic therapies to have a high clinical impact at the lowest cost to healthcare systems.