Monoclonal antibody treatments for paediatric severe asthma-outcomes, attitudes and adherence

Abstract

Asthma prevalence in Australian children is amongst the highest in the world. Despite appropriate inhaler technique and optimally dosed inhaled steroids, approximately 5% experience sustained symptoms. Monoclonal antibody treatments (biologics) are the fifth step in the Global Initiative for Asthma guidelines to treat severe asthma. Our retrospective cohort study aimed to evaluate the treatment effect of biologics for children with severe asthma at Sydney Children's Hospital, assess adherence to treatment and explore attitudes toward home administration using prefilled injection devices. We collected data for patients <18 years old receiving biologics to compare asthma control six months pre and post initiation of that therapy. We used participant and parent surveys to assess perceived change in asthma control and attitudes to home injections. 11 patients were recruited. Six months post biologic treatment there was a mean reduction in FeNO by 45% and ACQ-5 by 50% (p<0.01). 3 of the 6 patients requiring regular steroids ceased this treatment. The mean number of hospitalizations and oral steroid courses decreased by 17% and 29% respectively, though this was not statistically significant (p>0.05). We found no significant change in FEV1. Adherence was high. 64% of patients and carers perceived slightly/much better asthma control on biologics and 64% of carers indicated they would be slightly/much more happy with home injections. We conclude that biologic treatment leads to improved asthma control in Australian children eligible for and prescribed this therapy. Whilst adherence is high with health center based injections, carers are interested in home injections to reduce burden of care.L6381960872022-06-14 <br />