Persistent uncontrolled severe asthma despite widespread biologic use: care gaps from the French FASE2-CPHG real-world study.

Authors

L Portel, C Nocent-Ejnaini, E Parrat, P Verdoire, C Maurer, F F Goupil, N Texier, S Hervy, C Raherison-Semjen, H Morel, M Humbert

Published in

The journal of allergy and clinical immunology. In practice. Aug 14, 2026. Epub Aug 14, 2026.

Abstract

Biologic therapies have transformed the management of severe asthma, yet many patients in routine care remain symptomatic. Most real-world data originate from tertiary centers and may not reflect broader healthcare delivery.
To describe disease control, exacerbations, adherence, comorbidities, phenotypes, and care gaps in adults with severe asthma managed in French non-academic hospitals in the biologic's era.
FASE2-CPHG was a national, multicenter, cross-sectional study conducted between 2022 and 2023 in French non-academic hospitals. Adults with GINA 2022 Step 5 asthma were consecutively included during routine care. Physicians completed electronic case report forms and patients completed questionnaires assessing asthma control (ACT), adherence (Girerd score), anxiety and depression (HADS), and physical activity (Ricci & Gagnon's questionnaire). Clinical characteristics, biomarkers, imaging, exacerbations, and treatments including biologics were recorded.
Among 970 patients (mean age 54.5 ±15.8 years; 66.3% female), 71.2% were receiving biologic therapy. Despite these treatments, 59.8% had partially controlled or uncontrolled asthma according to ACT questionnaire. Globally, 62.6% experienced at least one exacerbation in the previous year. The median annual exacerbation rate was 1 (IQR 0-3). Only 31.6% of patients reported full adherence, whereas 88.7% were considered adherent by physicians. Anxiety and depressive symptoms were present in 45.6% and 24.6% of patients, respectively. Biologic therapy was prescribed in 71.2% of patients with omalizumab used in most case (41.2%). The mean duration of the ongoing treatment with biologics was 2.9 years (±5.1).
In routine non-academic hospital practice, biologics are widely implemented but a majority of patients remains uncontrolled. Major care gaps include unrecognized poor adherence, high psychological, metabolic and ENT comorbidity burden, and incomplete optimization of inhaled therapy. Addressing these gaps may yield gains comparable to the introduction of new biologic agents.

PMID:
42600982
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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