Document resource
Background and Importance Severe uncontrolled asthma (SUA) significantly impairs quality of life and increases healthcare resource use. Assessing adherence to inhaled therapy through the Test of Adherence to Inhalers (TAI) and dispensing data is essential before initiating biologic therapy, as adherence ensures treatment effectiveness.Aim and Objectives To evaluate adherence to inhaled therapy and the effectiveness of biologic treatment in adult patients with SUA.Material and Methods A retrospective observational study was conducted in adult patients diagnosed with SUA who started funded biologic therapies between March 2022 and September 2025. Variables included age, sex, asthma type, comorbidities, biologic treatment, TAI score and percentage of inhalers dispensed during the six months prior to biologic initiation. Effectiveness variables were Asthma Control Test (ACT), forced vital capacity (FVC), forced expiratory volume in one second (FEV 1), and FEV1/FVC ratio, measured six months before and after treatment initiation.Results Forty-one patients were included, 63.4% (26/41) women, mean age 60 ± 15 years and 48.7% (20/41) had mixed asthma. Comorbidities included rhinitis 65.8% (27/41), anxiety and/or depression 41.4% (17/41), atopic dermatitis 29.2% (12/41) and nasal polyposis 29.2% (12/41). Biologic therapies used were dupilumab 48.7% (20/41), benralizumab 24.4% (10/41), tezepelumab 12.2% (5/41), mepolizumab 12.2% (5/41), and reslizumab 1 patient. Mean TAI score was 52.1 ± 3.5 points. Median percentage of inhalers dispensed in the six months before biologic therapy was 83.3% (IQR 66.6–100%). Median ACT improved from 9 (IQR 8–15) to 21 (IQR 17.5–23) after six months of biologic treatment. Mean spirometric values before and after therapy were FVC 81.6 ± 14.2% vs 89.2 ± 18.6%, FEV 1 71.8 ± 21.3% vs 82.7 ± 18.3%, and FEV1/FVC 75.1 ± 20.3% vs 79.7 ± 17.2%.Conclusion and Relevance In patients with SUA, adherence to inhaled therapy was intermediate to high according to both TAI scores and dispensing data. The introduction of biologics was associated with improved asthma control and lung function. These findings highlight the importance of assessing adherence before initiating biologics and support their effectiveness in real-world clinical practice.Conflict of Interest No conflict of interest