Monoclonal antibody treatments for paediatric severe asthma --outcomes,
attitudes and adherence
Abstract
Aim: Asthma prevalence in Australian children is amongst the highest in
the world. 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. Method: 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. Results: 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. 73% of patients and carers perceived slightly/much better
asthma control on biologics and 73% of carers indicated they would be
slightly/much happier with home injections. Conclusion: 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.