“ [While comprising only 5% to 10%] of individuals with asthma, those with severe asthma account for a disproportionate share of the overall asthma burden, researchers wrote in the Journal of Asthma. “This subset of patients experiences frequent exacerbations and severe day-to-day impairment, leading to an overrepresentation of patients with severe asthma reducing their hours worked or prematurely leaving the workforce.”

Researchers investigated whether 2 years of biologic therapy improves workforce attachment, hours worked, and salaried income in a nationwide cohort of patients with severe asthma. The findings show that biologic therapy resulted in a moderate increase in hours worked; however, patients remain at considerable risk of premature workforce withdrawal.

Using a nationwide registry of all patients with severe asthma initiating biologic therapy, researchers identified 318 bionaïve patients with severe asthma and 1,461 matched controls. The study team tracked earned income, hours worked, and workforce attachment in national databases from 1 year prior to biologic therapy and 2 years of biologic therapy.

The mean age of patients was 49, and 52% were women. After 12 months of treatment, 18.5% of patients achieved remission, and 67% experienced a clinical response to treatment.

Improvements Following Start of Biologic Therapy

Results showed a significant reduction in work capacity and salary for patients with severe asthma compared with matched controls. Annual weeks worked were lower among patients with severe asthma (adjusted incidence rate ratio [aIRR], 0.82; 95% CI, 0.80-0.84), driven by increases in sick leave (aIRR, 2.77; 95% CI, 2.58-2.98), unemployment (aIRR, 1.38; 95% CI, 1.30-1.46), and disability pension (aIRR,1.85; 95% CI, 1.76- 1.94).

After starting biologic therapy, investigators observed a slight increase in annual hours worked at year 2 of treatment (aIRR, 1.03; 95% CI, 1.03- 1.04). However, patients with severe asthma remained at risk for temporary (OR, 1.83; 95% CI, 1.15-2.93) and permanent (OR, 2.67; 95% CI, 1.16-6.16) workforce withdrawal. Compared with non-responders, patients achieving clinical response or remission had considerably increased rates of employment and lower rates of unemployment and disability pension both at baseline and after 2 years of treatment.

“Two years of biologic therapy led to a slight increase in hours worked but did not lead to an increased return to work for patients outside of the workforce at baseline,” study investigators wrote. “Patients achieving remission had the strongest connection to the workforce both prior to and after biological therapy.”