Disease Impact and Perception of Biologics in Adults with Type 2 Inflammation Respiratory Disease: International Survey Results

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Purpose: There is a growing interest in developing approaches that reduce the impact of Type 2 inflammatory conditions, such as asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), on well-being. The aim of this international survey was to understand the impact of asthma and CRSwNP on people living with these conditions and to seek insight into the perception of biologics, which are often used to treat them. Patients and Methods: A cross-sectional survey was conducted anonymously online from February to May 2024. International participants were recruited through social media and by Survey Monkey. Individuals aged ≥ 18 years diagnosed by a medical professional with asthma and/or CRSwNP who lived in the US, Canada, UK, Germany, Italy, France, or Spain were eligible to participate. Results: Of the 1566 survey participants (56.7% asthma, 24.8% CRSwNP, 18.5% both), 52.5% were female, and 65.3% were ages 25– 54 years. Approximately two-thirds (64%) reported thinking once/day or at least once/week about managing their condition. Nearly half (44%) find it difficult to manage their disease. Of those currently using a biologic (14%), only 37% inject it themselves and feel confident doing so, and 42% felt it was a repeating reminder of their chronic condition. The top reason for stopping biologic treatment was that the injection/device was too difficult. The possibility of a lower frequency injection increased the likelihood participants would consider a biologic. Conclusion: The study further raises awareness of the personal burden from asthma and CRSwNP and their associated treatments in different countries. Beyond the goal of achieving clinical disease control for these diseases, a holistic approach to care delivery should include culturally appropriate emotional health support to improve overall well-being. Access to biologics administered with less frequency may alleviate some of the burden of self-injection. Plain Language Summary: Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are chronic (ongoing) diseases that can affect many aspects of life, and people often have both diseases. Biologic drugs can be used to treat asthma and CRSwNP not responding well to other treatments. These drugs need to be injected at home or in a doctor’s office every 2– 8 weeks. An online survey of patients around the world was done to understand the effects of these diseases on daily life and how people with these conditions feel about biologics. Of the 1566 participants, almost 57% had asthma, 25% had CRSwNP, and 19% had both. Participants said they worry about their disease, with 64% thinking every day or at least once/week about managing their condition and 44% finding it hard to take care of their disease. Of the people using a biologic drug, only 37% felt confident injecting it themselves, and 42% felt it was a reminder of their disease. The main reason for stopping a biologic was that the injection/device was too difficult. Patients said they would be more likely to take a biologic if the injection was needed less often. These results tell us asthma and/or CRSwNP negatively impacts well-being. For patients on biologics, worrying about injections and the constant reminder of their condition adds to their perception of burden. Emotional health supports and shared decision making with providers may help give patients confidence and lower anxiety. Having to get injections less often may lower the burden and anxiety people feel about self-injection. Keywords: asthma, chronic rhinosinusitis with nasal polyps, injection, burden

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