Real-Life Response to Biologics in Severe Asthma with Nasal Polyposis: Insights from the Belgian Severe Asthma Registry

Lung. 2024 Aug;202(4):441-448. doi: 10.1007/s00408-024-00715-0. Epub 2024 Jul 15.

Abstract

Background: Nasal polyposis (NP) is a comorbidity of type 2 severe asthma (SA) which could influence response to SA biologics.

Methods: We evaluated (super-) response in SA patients with (NP +) and without NP (NP-) enrolled in the Belgian Severe Asthma Registry (BSAR).

Results: 914 patients, of whom 31% NP + , were included. At enrollment, NP + patients had higher annual exacerbation rates, higher number of emergency room visits and more elevated type 2 biomarkers. In the longitudinal subanalysis of 104 patients, both groups had significant and similar asthma responses to asthma biologics, except for a greater increase in FEV1 in the NP + group. Super-response was achieved in 33 patients (32%), irrespective of NP status or type of biologic.

Conclusion: In conclusion, both NP + and NP - patients had positive treatment responses, with some able to achieve super-response. In SA patients with NP, a greater FEV1 improvement as compared to SA patients without NP was observed.

Keywords: Biologics; Nasal polyposis; Severe asthma; Super-response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Asthma* / drug therapy
  • Asthma* / epidemiology
  • Asthma* / physiopathology
  • Belgium / epidemiology
  • Biological Products* / therapeutic use
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps* / complications
  • Nasal Polyps* / drug therapy
  • Nasal Polyps* / epidemiology
  • Omalizumab / therapeutic use
  • Registries*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Biological Products
  • Anti-Asthmatic Agents
  • Omalizumab
  • mepolizumab
  • benralizumab
  • Antibodies, Monoclonal, Humanized