Biologic asthma therapy adherence is inconsistent

Don’t assume patients are following dosage and frequency instructions for their biologic asthma treatments. That’s the important message gleaned from a new study that uncovered significant insights into the adherence patterns of asthma patients using these therapies.

The study, “Low Adherence to Current Biologic Therapies in Asthma: From a Retrospective Cohort Analysis of Claims Data,” was conducted by researchers from GSK and Cytel Inc. and published in the Journal of Allergy and Clinical Immunology.

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Researchers analyzed U.S. data from the Optum Market Clarity database spanning 2007–2023 to assess the challenges faced by 10,088 patients in maintaining consistent use of these advanced treatments. They used heatmaps, medication possession ratio (MPR) and group-based trajectory modeling (GBTM) to visualize and identify distinct adherence patterns. Patients were prescribed one of six approved biologics, including omalizumab, dupilumab, mepolizumab, benralizumab, reslizumab and tezepelumab.

Justin Kwiatek, PharmD“Data on the efficacy and durability of biologic treatments are often based in the context of randomized controlled trials where adherence to the treatment on a set schedule is 100%,” said Justin Kwiatek, PharmD, senior director and U.S. medical affairs lead at GSK, in a Healio news release. “But in the real world, patients often do not stick to such strict dosing schedules, and it is important for clinicians to understand what the real-world dosing looks like for their patients, what affects their patients’ ability to stick to a regular schedule and how lower adherence can affect clinical outcomes.”

Key findings from the study include:

• Low average adherence: The average MPR across all biologics ranged from 21.9%–41.1%. Even among patients who received more than one dose during the follow-up period, the average MPR only increased from 30.1%–50.3%.
• Intermittent adherence: Heatmaps revealed that many patients exhibited intermittent adherence, with some resuming biologic therapy after significant gaps.
• Distinct adherence clusters: Group-based trajectory modeling (GBTM) identified eight distinct adherence clusters among 9,553 patients who did not switch biologics. These clusters included consistent adherence, early-drop, initial-only and U-shaped adherence patterns.
• Consistent adherence: Less than 15% of patients were consistently adherent across all biologic types.

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According to Dr. Kwiatek, the study provides a crucial understanding of the real-world challenges faced by asthma patients and highlights the important role of clinicians in developing effective strategies to improve adherence to biologic therapies.

Researchers also underscored the need for improved data collection, which could guide future, personalized interventions to enhance long-term asthma management.