Safety of biologics in severe asthmatic patients with SARS‐CoV‐2 infection: A prospective study

Abstract

Background Asthma guidelines have recommended continuing treatment with biologics during coronavirus disease 2019 (COVID‐19) pandemic. However, a continuation of treatment with biologics in patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has been little investigated. Objective To assess the safety of biologics in patients with SARS‐CoV‐2 infection. Methods A pilot, monocentric, prospective study. Patients aged 6 years old and older with severe asthma on treatment with biologics and confirmed SARS‐CoV‐2 infection were enrolled. Patients were followed‐up with periodic calls at different time points up to 3 months to detect any adverse effect and its relationship with biologic treatment according to the Naranjo Adverse Probability Scale (NAPS). The severity of SARS‐CoV‐2 infection and clinical outcome were also assessed. Results Overall, we included 21 patients (10 on therapy with omalizumab, 9 with dupilumab, and 2 with mepolizumab). Only a patient‐reported two local adverse events. No other adverse event was reported. Twenty out of 21 patients had a mild COVID‐19 course, and no adverse outcome was observed. Conclusion We showed that the scheduled dose of the biologic therapy can be administered safely on time in patients with SARS‐CoV‐2 infection, as the treatment did not result in adverse events or outcomes.

Safety of biologicals in severe asthma patients having COVID‐19

“…It is not clear in the article. 1 May the effects of varying lockdown processes, different comorbidities, younger study groups, the doses of biologics, and utilization period of biologicals used in this study population also have a role? Also, a detailed classification of the clinical spectrum of SARS-CoV-2 infection is given.…”

“…We have read the article titled "Safety of biologics in severe asthmatic patients with SARS-CoV-2 infection: A prospective study" by Sara Manti et al with great interest. 1 Since the literature data on the use of biologics in children are scarce, this study is very valuable.…”

“…In this study, 1 there are 21 patients (10 on therapy with omalizumab, 9 with dupilumab, and 2 with mepolizumab). Twenty out of 21 patients had a mild coronavirus disease 2019 (COVID-19) course, and no adverse outcome was observed.…”

“…Comorbidity of cystic fibrosis (71.45%) was detected in 15/21 of their patients. 1 This is a too-high ratio. Are their study group real cystic fibrosis patient groups rather than severe asthma patients?…”

“…As mentioned in the article, 1 type 2 inflammation is usually known to control the expression of angiotensin-converting enzyme 2 (ACE2) receptor in human bronchial cells and affects the COVID-19 outcome. In the table of the article, 1 it is shown that the number of users of inhaled bronchodilators is 11/21 patients, and inhaled steroids is 9/21 patients. According to the international asthma guidelines (e.g., GINA, american thoracic society, etc.…”