Related Experiment Video
Updated: Jul 12, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Biologic effectiveness increases with earlier biologic initiation after severe asthma onset
Arjun Mohan1, Reynold A Panettieri2, Wendy C Moore3
1Department of Medicine, Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich.
Background:
Patients with long-standing, uncontrolled, severe asthma can develop airway fibrosis and remodeling due to chronic inflammation, causing irreversible pulmonary damage.
Objective:
This analysis evaluated the effect of the time from severe asthma onset to initiation of a biologic on treatment effectiveness in US patients with subspecialist-treated severe asthma.
Methods:
CHRONICLE (ClinicalTrials.gov identifier NCT03373045) was an observational study of US adults with subspecialist-treated severe asthma who were receiving biologics or maintenance systemic corticosteroids or had persistently uncontrolled asthma despite high-dose inhaled corticosteroids and additional controllers. Annualized asthma exacerbation rates in the 12 months before and 12 months after initiation of biologic treatment were compared. Factors with a univariate association (P < .1) with the rate of exacerbation during treatment (12 months after initiation) were included in a multivariable model to identify independent, statistically significant associations.
Results:
This analysis included 244 patients enrolled between February 2018 and February 2024 who initiated biologic treatment and had complete data. Exacerbation rates decreased by 59% from the pre-biologic initiation period to the post-biologic initiation period. Multivariable analyses demonstrated a significant association between the rate of exacerbation during treatment and time from severe asthma onset to initiation of treatment with a biologic (rate coefficient = 1.04 [95% CI = 1.02-1.07]; P < .001) after adjustment for the preinitiation exacerbation rate (rate coefficient = 1.48 [95% CI = 1.30-1.68]; P < .001) and Black versus White race (rate ratio: 2.40 [95% CI = 1.25-4.61]; P = .009).
Conclusion:
With adjustment for factors including prior exacerbations and race, a shorter time from severe asthma onset to initiation of a biologic was associated with a lower rate of exacerbation during treatment and increased effectiveness of treatment with a biologic.
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