Home Biologics - A New Future for Children with Severe Asthma

Two trailblazing studies show that children on biologics can be treated and monitored from home.

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Adrian Monti

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For those with severe asthma, standard asthma treatments are largely ineffective and symptoms and attacks are difficult to control, making everyday life unpredictable. Recently developed biologic treatments offer hope. Biologics work differently than traditional asthma treatments and can improve symptoms and reduce asthma attacks by helping to stop processes that cause lung inflammation. If a biologic treatment works well, it can also reduce the need for regular steroid use.

Though most biologics have been approved for home administration, most experience shared has been with adult populations. Typically, children with severe asthma on biologics are required to visit the hospital every 2-4 weeks for their treatment injections and assessments.

With the onset of Covid-19, hospitals were forced to limit in-person visits and naturally, many families were reluctant to attend appointments. Frequent hospital visits also generally mean time off school and work, which is a constant burden for families.

However, two trailblazing studies in the UK now show that children and adolescents with severe asthma on biologics can be treated and monitored from home, which brings a new patient-centric and life-altering option to families.

Treatment, monitoring and clinic appointments from home

A study published from London’s Royal Brompton Hospital assessed the safety and effectiveness of this approach. Injections were carried out at home, mostly by patients or their parents after a face-to-face training session. Administration was then observed virtually, allowing a nurse specialist to watch and advise if needed.

In addition to home administered injections, NuvoAir Home spirometry was used along with other assessments, including an Asthma Control Test and quality of life questionnaire to monitor patients from home monthly. Virtual clinical appointments were held every three months, creating a new home-based package of care.

A similar study was presented by Birmingham Women’s and Children’s Hospital at the King’s John Price Paediatric Respiratory Conference in May 2021. Though home administration wasn’t suitable for all families, the study showed most were able to do so successfully and with a high level of satisfaction.

In both studies, families were provided with the NuvoAir Home platform including a bluetooth spirometer and connected app that allows data to be shared in real time with the care team. Respiratory physiologists trained the children and parents on how to use the NuvoAir technology to ensure spirometry was being performed correctly. High spirometry adherence with NuvoAir Home allowed the same quantity and quality of data to be reviewed as if it were performed at the hospital. The Royal Brompton study shares, “Home spirometry represented another milestone in our service and was effective in providing accurate lung function data prior to the virtual appointments.”

Sue Frost, Respiratory Nurse Specialist at Birmingham Children’s Hospital also emphasized the importance of home spirometry as a part of home biologic administration, “Patients can say they are feeling well, but lung function tells the truth.”

Families welcome this new approach

Children and their families provided positive feedback to this home-based approach. Participants of the Royal Brompton Hospital study were reassured that they were being closely monitored, found NuvoAir Home easy to use, and were relieved that they did not have to travel to the hospital.

Amy Burrill, Respiratory Physiologist at Birmingham Children’s Hospital shared, “Many families are grateful for not having to miss so much school. Instead of up to two hours traveling in some cases, it’s about 15 minutes out of their day every two weeks or so.” Though not meeting physically, families taking part in the Birmingham study also felt more in touch with their child’s care team.

Parents felt reassured when the care team observed virtually when injecting, which reduced anxiety of doing a task normally carried out by healthcare professionals. “I was scared I might hurt my child, however, we managed well enough and now I feel fine doing them,” said a parent taking part in the Royal Brompton study. A family participating in the Birmingham Children’s study said, “Giving the injection in the kitchen actually makes it less of a big thing.”

Although it may not be suitable for all patients, both hospitals who have piloted this approach believe the new home care model for children on biologics will become routine practice going forward, with frequent hospital trips becoming a thing of the past.