Work

Impact of biologic therapy on blood cell indices and exacerbation risk in severe asthma: predictive value of the neutrophil-to-eosinophil ratio

Year: 2025

Type: article

Abstract: Background: Although biologic therapies have transformed the management of severe asthma, reliable blood-based markers to measure treatment response and predict residual exacerbation risk remain limited. The aim of this study was evaluating routine hematologic indices as predictors of disease control and exacerbations after biologic therapy. Methods: A cohort study included 107 patients with severe asthma were assessed before and after one year of initiating biologics. Asthma control was measured with the Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ-6); exacerbations were prospectively recorded. Complete blood counts were obtained at both time-points. Results: = 0.04) as independent predictors of exacerbation, with ROC analysis showing their significant discriminative ability (AUC 0.64-0.66). Depending on the clinical objective to rule out or confirm exacerbation risk, specific cutoffs for NER (>3.97) and monocytes (>435/µl) offered high sensitivity (∼92%), or high cutoffs for NER (>50.65) and monocytes (>755/µl) offered high specificity (∼91%). Conclusion: Biologic therapy significantly reduced eosinophils and altered NER in severe asthma. Prominently, elevated post-treatment neutrophils, monocytes, and particularly a higher NER, were significant predictors of poorer asthma control and increased exacerbation risk, offering clinically useful biomarkers for personalized management.

Source: Frontiers in Allergy

DOI: 10.3389/falgy.2025.1691886

Authors: Mona Al-Ahmad, Asmaa Ali, Wafaa Talat

Institutions: Kuwait University, Ministry of Health, Jiangsu University, Ministry of Health and Population

Language: English

Topic: Asthma and respiratory diseases

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,077