The experience of dual biologic therapy in patients with eosinophilic asthma and autoimmune diseases

Background: The introduction of biologic therapy in the management of eosinophilic asthma (EA) and autoimmune diseases (AD) has led to an outstanding improvement of the course of disease and prognosis. However, there is a limited amount of evidence regarding efficacy and safety of the synchronous use of different biologic agents in these diseases. Aims and Objectives: We aim to present a binational multicentre retrospective series of patients with EA and other AD that received dual biologic therapy, with an emphasis on the efficacy and safety of treatment. Methods: The registries of two referral centres in France and Greece were searched for patients that synchronously received different biologic agents for EA and other AD, and their core and follow-up data were retrieved and analysed. Results: Seven female patients aged 55-70 years were investigated. All patients were diagnosed with severe EA (GINA stage 5) and concurrent AD, including rheumatoid arthritis (5 patients), psoriatic arthritis (1 patient), and non-radiographic axial spondyloarthritis (1 patient). All of them synchronously received mepolizumab for EA and another biologic agent (adalimumab, certolizumab, etanercept, rituximab, or secukinumab) for their AD for different periods with a duration ranging from 6 to 44 months. During the dual biologic therapy period, no drug-drug interactions leading to potential efficacy impairment and/or adverse effects or complications were observed. Conclusions: Preliminary results support that synchronous biologic therapy with different agents in EA and AD is feasible with the conservation of their individual efficacy and the absence of any notable adverse outcomes.