Home-based treatment of biologics for asthma: who, what, where, when and why

ABSTRACT

Introduction

The advent of biologic therapies for severe asthma has profoundly changed the management of this pathology. The introduction of home administration is therefore an important innovation to optimize the patients’ management, even if there are many aspects that need to be clarified and pointed out.

Areas covered

This review summarizes the path that led to the possibility of self-administration of biologics, and what the pandemic has changed in the management of these patients.

Expert opinion

The growing understanding of asthma phenotypes and endotypes is enabling the careful selection of patients suitable for biologics. In this context, the availability of reliable and simple self-injection devices is important in implementing self-administration. The transition to self-injection is also possible thanks to the high safety profile of biologics. With attention, most patients may potentially be suitable for self-administration. The transition process from hospital to home administration can therefore be carried out correctly by clinicians with adequate expertise in the field of severe asthma and biologic therapies, with the support of other health professionals, pharmacists, and general practitioners. Home administration is probably the best way to guarantee high adherence and high-level satisfaction of patients, even in the long term.

KEYWORDS:

• Biologics
• home administration
• safety
• self-administration
• severe asthma
• therapy

Declaration of interest

Francesco Menzella has received research grants from AstraZeneca, Novartis, and Sanofi; lecture fees and advisory board fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Mundipharma, Novartis, and Sanofi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Article highlights

• The present review summarizes the most recent evidence on home administration of biologics in asthma in order to highlight the advantages derived from auto-injection.

• All biologics are approved for home administration in pre-filled syringes or autoinjectors.

• The data available, also in the long-term, indicate that patients can carry out biologic therapies in absolute safety at home after a correct training.

• Self-administration is cost effective and time saving for health care professionals and patients.

• The pandemic has severely affected health services which have had to quickly reorganize. Home therapy had a great development during this period and allowed the continued treatment of patients with severe asthma safely.

• The transition process from hospital to home therapy can be carried out for the majority of patients correctly by clinicians with adequate expertise in the field of severe asthma.

• Pharmacists and general practitioners can play a key role in managing patients who are prescribed home administration.

Additional information

Funding

This paper was not funded.