Abstract Introduction Asthma is a chronic reactive airway disease that affects more than 23 million adults in the US. Obesity has been reported as an important factor in the development and treatment responsiveness to asthma. The introduction of biologic treatment has significantly decreased exacerbation rates and hospitalization in patients with severe asthma. Understanding how well biologic treatments work in patients with obesity is important, as these therapies have been effective to be used as steroid-sparing agents. As majority of our patients are from underserved communities where obesity is common, we conducted this study to assess whether biologics are effective in controlling asthma among obese and non-obese patients. Methodology We conducted a retrospective review of medical records of adult patients with asthma who received biologic therapy at Cook County Hospital from January 1, 2021, to August 30, 2024. Inclusion criteria were: patients with age ≥ 18 years, confirmed diagnosis of asthma and who had been on biologic treatment for ≥ 6 months. Patients were categorized based on Body Mass Index (BMI), with values 30 classified as non-obese and ≥ 30 as obese, and both groups were assessed for asthma control after biologics. Results A total of 108 patients (44 non-obese, 64 obese) who received biologic therapy were evaluated to assess the potential influence of obesity on treatment response. Biologic intervention significantly improved asthma control in both groups, with well-controlled rates increasing from 9% to 55% in the non-obese and 9% to 62% in the obese category (p 0.001 for both) (Figure). Similarly, biologic treatment also reduced nighttime symptoms in both groups from 64% to 11% in the non-obese and 59% to 20% in the obese cohort (both p 0.001). Biologic therapy also helped to significantly benefited in decreasing the number of exacerbations, activity limitations, and requirement of rescue medication in both groups (p 0.001 for all). Among the obese patients, 55% had BMI ≥ 40, patients in this category also had significant improvement in asthma control after biologics (p 0.001). When both the cohorts were compared, there was no difference in response to treatment across all measured parameters: nighttime symptoms (p 0.164), activity limitations (p 0.213), exacerbation episodes (0.432), and rescue medication need (0.46). Conclusion Biologic therapy significantly improved asthma control in both obese and non-obese patients. Conducted in a safety-net hospital serving an underserved population with high obesity rates, this result strengthens the rationale of using biologic therapy among both the categories. This abstract is funded by: None
Thapa et al. (2026) studied this question.