D1.125 - Biological therapy in severe asthma: 20 years of experience at the Hospital Universitario de Burgos

Biological therapy has revolutionized the management of severe asthma, particularly in patients with a type 2 immune response who remain uncontrolled despite conventional treatments. In recent years, the introduction of new biologics has enabled individualized therapy, optimizing symptom control and enhancing patients' quality of life.

A retrospective, descriptive study was conducted to review the experience of biologic use for severe asthma treatment in the Allergology Department of the Hospital Universitario de Burgos (HUBU) over the past 20 years.

A total of 46 patients (54% male, 46% female) received biologic therapy, with an average age of 38 years at the start of treatment. The most common aeroallergen sensitizations were to mites (59%), grass pollen (52%), and dog epithelium (30%). Additionally, 28% of patients had previously undergone specific immunotherapy in an attempt to control allergic exacerbations.

A total of 54 biologic therapies were prescribed: Omalizumab (78%), Dupilumab (11%), Mepolizumab (7%), and Tezepelumab (4%). Spirometric improvement (defined as an increase of more than 10% in FEV1 values) was observed in 48% of patients, while 80% experienced clinical improvement. However, when biologic agents were switched in 8 patients, the overall clinical improvement rate increased to 95%.

Our findings confirm the positive impact of biologics in the treatment of severe asthma. The use of these therapies has progressively increased, with Omalizumab being the most widely used due to its early availability. However, the arrival of new biologics expands therapeutic options, and their use is expected to rise, enabling more personalized and effective treatment approaches.