PP19 CHECKLIST-GUIDED BIOLOGIC THERAPY IN SEVERE ASTHMA: A SINGLE-CENTRE EXPERIENCE

Fatimah Azmah Mohammad, LeAnn Chong, Nor Syamimi Mohd Isa, Noorul Afidza, Mona Zaria, Leong SW, Haly Rozie

Hospital Sultan Idris Shah Serdang, Selangor, Malaysia

Introduction
Biologic therapy has improved asthma control in patients with Type 2 (T2) inflammation. However, challenges remain in ensuring appropriate patient selection, treatment monitoring, and consistent access.

Objectives
To evaluate the effectiveness of biologic therapy in severe asthma using a structured checklist-based approach, and to identify real-world access challenges in a tertiary center.

Methodology
A retrospective review was conducted involving 24 patients with severe asthma treated with biologics at Hospital Sultan Idris Shah, Serdang, between 2020 and 2025. Data collected included asthma phenotype, blood eosinophils, IgE, ACT scores pre- and post-treatment, and biologic type. Initiation and follow-up checklists were used to guide treatment decisions and assess response after 3-6 months.

Results
Eosinophilic (23%) and mixed allergic–eosinophilic (16%) phenotypes were most common. Biologics prescribed included Omalizumab (n=4), Benralizumab (n=9), Dupilumab (n=8), and Tezepelumab (n=3). Mean eosinophil count was 766 cells/μL and IgE 835 IU/mL. ACT scores improved from 13.8 to 21.0. Better responses were seen in eosinophilic phenotypes. Checklists supported accurate patient selection, optimization of comorbidities and adherence, and systematic response monitoring. However, funding delays and quota restrictions resulted in treatment interruptions or less suitable biologic choices.

Conclusions
Biologic therapy improved asthma control in appropriately selected patients, particularly those with eosinophilic inflammation. A structured checklist-based approach enhanced selection and monitoring. Access and funding limitations remain key barriers to sustained care.