D3.424 - Retrospective Analysis of Self-Administration of Biologic Treatments for Severe Asthma and Chronic Urticaria

Although autoinjectors and prefilled syringes (PFS) are available for home self-administration of biologic therapies used in severe asthma and chronic urticaria, real-world data regarding patient use remain limited. This study aimed to retrospectively examine their usage among patients receiving biologic therapy for severe asthma or chronic urticaria and to identify factors that may present challenges to self-administration.

This observational, single-center study included patients with a confirmed diagnosis of severe asthma or chronic urticaria who had been receiving treatment with omalizumab, mepolizumab, or benralizumab for at least four months at a tertiary care adult allergy clinic between December 2020 and December 2024. 

A total of 91 patients receiving biologic therapy were analyzed. Of these, 67 (73.6%) were female, and the median age was 47.0 years (range: 20.0–82.0). Seventy patients (76.9%) were receiving omalizumab, 16 (17.9%) mepolizumab, and 5 (5.5%) benralizumab. The mean duration of biologic treatment was 29.8 ± 27.1 months. The results showed that 34 (37.3%) of patients self-administered the medication, with 24 (70.6%)  patients administering it themselves, 5 (14.7%) patients by a spouse/partner, and 5 (14.7%) patients by another family member.

Moderate/high anxiety was observed in 27 (47.4%)  patients in the no self-administration group and 8 (23.5%)  patients in the self-administration group (p=0.024). In the comparison of baseline characteristics between male and female patients, the proportions of retired or housewife status, and baseline total Beck Anxiety Inventory scores were significantly higher in females (p < 0.001 and p = 0.007, respectively). Multivariate logistic regression analysis revealed that female sex (OR = 3.73; 95% CI: 1.0–13.3; p = 0.040) and moderate-to-severe anxiety (OR = 3.61; 95% CI: 1.3–9.8; p = 0.012) were significant independent risk factors for avoidance of self-administration.

Our study demonstrated that less than half of the patients undergoing biological treatment engaged in self-administration, with concerns being a significant barrier. High general anxiety significantly obstructed self-administration, emphasizing the need for educational and psychological interventions to improve confidence and adherence.