In real-world practice, how much does sticking to biologic therapy actually matter for patients with severe asthma? According to new findings from the CHRONICLE study, the answer is: quite a lot.
CHRONICLE (NCT03373045) followed over 700 adults with severe asthma in the United States between 2018 and 2024. Participants initiated one of six biologics - benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab, or tezepelumab - and stayed on it for at least a year. Researchers measured adherence by the proportion of days each patient had their biologic “covered” and compared that to changes in exacerbation rates before and after treatment.
Only about half (47%) maintained ≥90% adherence, and another 15% were in the 80–89% range. Notably, dupilumab users were more likely than others to fall below 50% adherence (32% vs. 2.6–8.3%).
The impact of this difference was striking: among patients who had at least two exacerbations in the year before treatment, better adherence correlated with bigger reductions in annualized exacerbations. In simple terms, those who stayed on schedule saw fewer flares, fewer steroid bursts, and fewer hospitalizations.
The message for clinicians is clear: in severe asthma management, biologic adherence isn’t just a metric - it’s a major determinant of therapeutic success. As new biologics expand our toolbox, maintaining engagement and consistency may be just as important as choosing the right agent in the first place.
References:
https://www.sciencedirect.com/science/article/pii/S0091674925013041