Biological treatments expand options for severe asthma patients

The experts pointed out that asthma is not a single disease with a uniform pattern, but rather it has multiple forms, triggers, and degrees of response to treatment, making accurate diagnosis and the selection of appropriate treatment for each patient essential for controlling the disease.

Specialists warned against confusing uncontrolled asthma with severe asthma, explaining that the persistence of symptoms does not necessarily mean that the patient is suffering from a severe condition that requires biological treatment.

A pooled analysis estimated its prevalence among children and adolescents at about 8.24%, while data from the third phase of the International Study of Asthma and Allergies in Childhood and Adolescence (ISAAC) showed that the percentage of physician-diagnosed asthma among school children ranged between 8.8% and 9.5%.

The impact of the disease is not limited to respiratory symptoms, but extends to sleep, study, work, and access to healthcare services.

According to the regional AIRGNE study, which included patients from Jordan, 68% reported daytime symptoms, 51% reported waking up at night, 52% reported visiting emergency departments in the previous twelve months, 23% were hospitalized, and asthma-related absenteeism was 69% among students and 46% among working adults.

For his part, Dr. Khaled Shujaa Al-Assad, President of the Jordanian Society of Respiratory Diseases and Consultant in Respiratory Diseases, Intensive Care, and Sleep Medicine, explained the impact of uncontrolled severe asthma on patients' lives, saying, 'Asthma management should not be limited to relieving symptoms, but should aim for sustained control that improves the patient's life in the long term.'

He added that innovative treatment options provide additional possibilities for patients who do not achieve the required control.

He emphasized that errors in using inhalers or irregular medication intake may make the patient's condition appear more severe than it actually is, necessitating a review of the treatment plan and educating the patient before transitioning to advanced treatment stages.

According to Al-Assad, the evaluation requires first ensuring the patient's adherence to the prescribed treatment, using the inhaler correctly, and controlling smoking, exposure to irritants, allergies, and comorbid diseases, before concluding that the case is unresponsive to conventional treatments.

For his part, Professor of Medicine and Head of the Department of Respiratory Diseases and Sleep Medicine at the University of Jordan Hospital, Dr. Khaled Al-Owaidat, explained the clinical developments in the treatment of severe asthma, where targeted biological treatments offer more suitable options for each patient's condition and may contribute to reducing the frequent reliance on oral corticosteroids, while specialized evaluation and the selection of appropriate treatment remain fundamental to achieving the best results.

He pointed out that biological drugs are not given to every asthma patient, but rather to specific categories selected according to medical criteria that include the severity of the disease, the number of attacks, the frequent need for corticosteroids, and the results of clinical and laboratory tests.

Al-Owaidat stressed that biological treatment does not constitute an automatic alternative to inhalers and basic treatments, and should not be initiated or discontinued except within a treatment plan supervised by a specialist in respiratory diseases and allergies.

He noted that biological treatments for asthma are available in Jordan through the Ministry of Health according to specific conditions and protocols, in addition to university hospitals, the private sector, and some insurance entities.

Despite the high direct cost of biological treatments, experts believe that evaluating their cost should not be limited to the price of the drug alone, but should take into account the potential reduction in severe asthma attacks, emergency visits, frequent hospital admissions, and absenteeism from work.

It should be noted that the 'Tezspire' treatment targets the thymic stromal lymphopoietin (TSLP) protein, one of the main factors that trigger inflammation associated with severe asthma, intervening early in the inflammation chain and helping eligible patients to achieve better control of the disease.

The new treatment has been approved for the treatment of severe asthma in more than 70 countries and has been used by more than 100,000 patients worldwide since 2021. The efficacy and safety of tezepelumab are being evaluated in adult participants with chronic obstructive pulmonary disease of moderate to very severe degrees in the 'JOURNEY' 4 and 'EMBARK' 5 studies.

Clinical studies in adults and adolescents aged 12 years and older have shown a reduction in the annual asthma exacerbation rate compared to placebo by 71% in the 'PATHWAY' study and 56% in the Phase 3 'NAVIGATOR' study, alongside improvements in lung function.

Osama Atta Allah, General Manager of AstraZeneca Jordan, said, 'Improving the lives of patients with chronic diseases is a priority that drives our efforts to provide new treatment options that give them a more active life and less affected by the disease. We continue our commitment to supporting the future of healthcare in Jordan through scientific innovation and collaboration with healthcare providers to improve the outcomes of severe uncontrolled asthma patients.'