Can Biologics Cut Steroid Exposure in Aspirin-Exacerbated Respiratory Disease?

aspirin pills bottle
aspirin pills bottle
A retrospective review presented at ACAAI 2021 assessed median cumulative corticosteroid exposure before and after initiation of biologic therapy in AERD.

The following article is a part of conference coverage from the American College of Allergy, Asthma & Immunology 2021 Annual Scientific Meeting, being held virtually from November 4 to 8, 2021. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the ACAAI 2021 Annual Scientific Meeting.


Biologic therapy may reduce cumulative systemic steroid exposure in aspirin-exacerbated respiratory disease (AERD), according to authors of a retrospective study  presented at the 2021 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, held in New Orleans, LA, from November 4 to 8.

To assess whether the cumulative systemic corticosteroid exposure in patients with AERD differs after initiating a respiratory biologic therapy, the investigators conducted a retrospective chart review of patients who received biologic therapy lasting at least 12 months.

Total systemic corticosteroid use in the 12-month period before and after initiation of 1 of the 5 respiratory biologic therapies approved by the US Food and Drug Administration. The primary outcome was median cumulative corticosteroid exposure pre- and post-initiation of the biologic therapy.

In total, 32 patients initiated a biologic therapy (omalizumab, n=5; dupilumab, n=23; benralizumab, n=2; and mepolizumab, n=2). Prior to starting biologic therapy, the median cumulative steroid exposure was 215 mg, while after initiating therapy, it was 0 mg, yielding a median change of −178.2 mg (P <.0001).

In comparing outcomes with specific biologic agents, the researchers found a significant change among patients receiving dupilumab (median change in steroid exposure, −156.3 mg; P =.0008). Patients receiving treatment with omalizumab had a median change of −300 mg; P =.18). Due to the small sample sizes, statistical analyses could not be performed on the data from patients receiving benralizumab and mepolizumab (median change, −835 mg and −697.5 mg, respectively).

“Biologic therapy in AERD appears to significantly reduce cumulative steroid exposure in the 12-month period following initiation,” the investigators concluded.


Visit Pulmonology Advisor’s conference section for complete coverage of ACAAI 2021 Annual Scientific Meeting.



Ghiasi Y, Wangberg H, Spierling Bagsic S, White A. A new frontier: Do biologics reduce cumulative steroid exposure in AERD? Presented at: American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting; November 4-8, 2021; New Orleans, LA. Abstract P025.