There is limited information about outcomes associated with stopping asthma biologics.
To compare outcomes in people who stopped or continued asthma biologics.
We identified a cohort of people with asthma who stopped or continued asthma biologics in the Optum Labs Database Warehouse, using a propensity matching method for case and control groups with the variables age, sex, race, region, insurance, income, specialist access, Charlson comorbidity, specific medical conditions, pre-index exacerbation count, pre-index rescue inhaler pharmacy fills, and pre-index inhaled corticosteroid +/- long-acting β-agonist pharmacy fills. The primary outcome used to assess failure of stopping was an increase of 50% or more in the asthma exacerbation rate in the six months after discontinuing the biologic compared to the six -month period before biologic initiation.
Among a cohort of 4,960 asthma biologic users, 1,249 were observed to stop use after 6-12 months of use. We identified a matched cohort of 1,247 stoppers and 1,247 people who continued biologic use for at least 18 months. In the first 6 months after stopping/sham stopping, 10.2% of stoppers and 9.5% of continuers had an increase of 50% or more in asthma exacerbations. We found a similar adjusted odds of failing among stoppers and continuers [OR: 1.085; (95% CI 0.833 to 1.413)].
An increase in asthma exacerbations is infrequently observed in people who stopped asthma biologics and was observed at similar rates as in matched controls who continued asthma biologics.

Copyright © 2021. Published by Elsevier Inc.