Menu
  • Login
  • Search

Allergologie select, Volume 10 (2026) - 1st issue (158 - 169)

Choosing and switching biologics for patients with severe asthma: Real-world data from the German Asthma Net (GAN)
Alexandra Lenoir1, Roland Buhl2, Carlo Muemmler1,16, Jürgen Behr1, Rainer Ehmann3, Eckard Hamelmann4, Anette Holtdirk5, Marco Idzko6, Margret Jandl7, Frank Kaessner8, Olaf Schmidt9, Christian Schulz10, Dirk Skowasch11, Hendrik Suhling12, Christian Taube13, Stephanie Korn14, Katrin Milger1, 15;, GAN investigators
1 Department of Medicine V, LMU University Hospital, Comprehensive Pneumology Center (CPC), Member of the German Center of Lung Research (DZL), LMU Munich, Munich, 2 Mainz University Hospital, Pulmonary Department, Mainz, 3 Ambulante Pneumologie mit Allergiezentrum, Stuttgart, 4 Kinderzentrum Bethel, Evangelisches Klinikum Bethel, University Bielefeld, Bielefeld, 5 RQMplus Germany, Ahlen, Germany, 6 Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria, 7 Hamburger Institut für Therapieforschung GmbH, Hamburg, 8 Ambulantes Zentrum für Lungenkrankheiten und Schlafmedizin, Cottbus, 9 Pneumologie Mittelrhein und Studienzentrum KPPK, Bendorf am Rhein, 1  0 Clinic and Polyclinic of Internal Medicine, Department of Pneumology, University Hospital Regensburg, University of Regensburg, Regensburg, 1  1 Department of Internal Medicine II - Pneumology, University Hospital Bonn, Bonn, 1  2 Pneumologicum Hannover, Hanover, 1  3 Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, 1  4 IKF Pneumologie Mainz and Thoraxklinik Heidelberg, Mainz and Heidelberg, Germany, 1  5 Division of Respiratory Medicine, Department of Internal Medicine, Lung Research Cluster, Medical University of Graz, Graz, Austria, and 1  6 Institute of Lung Health and Immunity (LHI), Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), Munich, Germany

     

 

DOI 10.5414/ALX02636E

Abstract

With six biologics available to treat severe asthma in 2025, choosing the optimal initial therapy and deciding to which other biologic to switch in case of insufficient benefit is challenging. To better understand patients’ characteristics depending on the chosen biologic and patterns of switch, we evaluated adult patients with severe asthma from the GAN registry who were biologic-naïve at baseline. Between 2011 and 2024, 2,649 patients with severe asthma newly received a biologic, 26% anti-interleukin-5 receptor (IL5R), 25% anti-IL5, 16% anti-IL4R, 24% anti-immunoglobulin E (IgE), and 9% anti-thymic stromal lymphopoietin (TSLP). Distribution of biologics varied between time periods, reflecting their availability over time. Patients treated with anti-IgE were youngest at asthma diagnosis (mean 26 years) and had the highest rates of allergic comorbidities (80%). Blood eosinophils were highest in patients receiving anti-IL5R (median 433/µL) and lowest in those receiving anti-TSLP (median 159/µL), while FeNO was highest in patients treated with anti-IL5, anti-IL5R, or anti-IL4R (median 39, 38, and 35 ppb, respectively). 14.3% (n = 378) of patients were switched from the first biologic to a different one. The most frequent switch constellations were anti-IL5 to anti-IL5R, anti-IL5R to anti-IL4R, and anti-IL5 to anti-IL4R. After a switch, depending on the constellation up to 46% of patients reached remission. Phenotyping patients with severe asthma determines the choice of biologic therapy in real-world practice. Choice and switch of biologic have evolved over time influenced by availability of different drugs. Our analysis supports the practice of switching to a different biologic in case of insufficient initial response.

Author Details

Authors

Departments

  • 1 Department of Medicine V, LMU University Hospital, Comprehensive Pneumology Center (CPC), Member of the German Center of Lung Research (DZL), LMU Munich, Munich,
  • 2 Mainz University Hospital, Pulmonary Department, Mainz,
  • 3 Ambulante Pneumologie mit Allergiezentrum, Stuttgart,
  • 4 Kinderzentrum Bethel, Evangelisches Klinikum Bethel, University Bielefeld, Bielefeld,
  • 5 RQMplus Germany, Ahlen, Germany,
  • 6 Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria,
  • 7 Hamburger Institut für Therapieforschung GmbH, Hamburg,
  • 8 Ambulantes Zentrum für Lungenkrankheiten und Schlafmedizin, Cottbus,
  • 9 Pneumologie Mittelrhein und Studienzentrum KPPK, Bendorf am Rhein,
  • 1 
  • 0 Clinic and Polyclinic of Internal Medicine, Department of Pneumology, University Hospital Regensburg, University of Regensburg, Regensburg,
  • 1 
  • 1 Department of Internal Medicine II - Pneumology, University Hospital Bonn, Bonn,
  • 1 
  • 2 Pneumologicum Hannover, Hanover,
  • 1 
  • 3 Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen,
  • 1 
  • 4 IKF Pneumologie Mainz and Thoraxklinik Heidelberg, Mainz and Heidelberg, Germany,
  • 1 
  • 5 Division of Respiratory Medicine, Department of Internal Medicine, Lung Research Cluster, Medical University of Graz, Graz, Austria, and
  • 1 
  • 6 Institute of Lung Health and Immunity (LHI), Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), Munich, Germany

Address

Katrin Milger, MD, Division of Respiratory Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
Email: [email protected]

Citation

Alexandra Lenoir, Roland Buhl, Carlo Muemmler, Jürgen Behr, Rainer Ehmann, Eckard Hamelmann, Anette Holtdirk, Marco Idzko, Margret Jandl, Frank Kaessner, Olaf Schmidt, Christian Schulz, Dirk Skowasch, Hendrik Suhling, Christian Taube, Stephanie Korn, Katrin Milger; and GAN investigators.Choosing and switching biologics for patients with severe asthma: Real-world data from the German Asthma Net (GAN). Allergologie select. 2026; 10: 158-169. doi: 10.5414/ALX02636E.

###article_not_exists_msg###

Shopping Overview

Shopping Overview
Type Qtty Discount VAT Price
Your basket is empty
View Cart