Criteria to evaluate efficacy of biologics in asthma: A Global Asthma Association survey

Angelica Tiotiu, Andras Bikov, Francisco-Javier Gonzalez-Barcala, Sylvia Novakova, Plamena Novakova, Chong-Neto Herberto, Santus Pierachille, Ansotegui Ignacio, Ivancevich Juan Carlos, Kowal Krzysztof, Mihaicuta Stefan, Nedeva Denislava, Canonica Giorgio Walter, Bernstein Jonathan, Boulet Louis Philippe & Braido Fulvio

ABSTRACT

Background

Currently there are no universally accepted criteria to measure the response to biologics available as treatment for severe asthma. This survey aims to establish consensus criteria to use for the evaluation of response to biologics after four months of treatment.

Method

Using Delphi methodology, a questionnaire including ten items was validated by 13 international experts in asthma. The electronic survey circulated within the Interasma Scientific Network platform. For each item, five answers were proposed graduated from ‘no importance’ to ‘very high importance’ and by a score (A = 2 points; B = 4 points; C = 6 points; D = 8 points; E = 10 points). The final criteria were selected if the median score for the item was ≥ 7 and > 60% of responses according ‘high importance’ and ‘very high importance’. All selected criteria were validated by the experts.

Results

Four criteria were identified: to reduce daily systemic corticosteroids dose by ≥ 50%; to decrease the number of asthma exacerbations requiring systemic corticosteroids by ≥ 50%; to have no/minimal side-effects and to obtain asthma control according validated questionnaires. The consensual decision was that ≥ 3 criteria define a good response to biologics.

Conclusions

Specific criteria were defined by an international panel of experts and could be used as tool in clinical practice.

Expert Review of Respiratory Medicine, DOI: 10.1080/17476348.2023.2223986