{
  "abstract": "Introduction and Objectives Biologic therapies have proven to be effective at reducing the need for background medications. 1 GINA recommend stepping down maintenance treatment in patients with well-controlled asthma2; however, there remains a lack of consensus on how to safely taper background medications, including ICS, in patients with severe asthma on biologic therapy.Methods A targeted literature review (TLR) evaluated evidence on reducing background medication in adults with controlled severe asthma on biologic therapy. Two surveys were conducted to gain further insights from UK respiratory healthcare professionals (HCP) and patients.Results TLR: data from 24/25 of the publications extracted supported a reduction of background medications for patients with controlled asthma after biologic treatment. A step-wise reduction in ICS dose was recommended in 18 publications, however, standard tapering criteria of medication or discontinuation sequences and monitoring requirements were not established.HCP survey: Of the 26 participants, 77% (20) assess the patient’s suitability for background medication reduction and 65% (17) always or often consider tapering background medication when escalating therapeutic management. To support the clinical application of background medication reduction in asthma management plans, 66% (17) of HCPs highlighted the need for evidence generation, protocols and guidance.Severe Asthma Patient survey: Of the 41 patients surveyed, 83% (34) believe that reducing background medication is very or somewhat important when asthma is well-controlled on biologic therapy; 46% (19) of patients lower the dose of other asthma medication independently of medical advice. Two key barriers to reducing background medications were fear of asthma deterioration and other undesirable effects. Commonality in the need for guidance in treatment titration and monitoring was seen across the two surveys (table 1).Abstract P207 Table 1Selected key questions and results from the asthma specialist HCP and severe asthma patient surveysConclusion The TLR supports background medication reduction in well-controlled asthma patients receiving biologic treatment; however, current guidance on the optimal reduction strategy is sparse. Consensus recommendations and protocols, based on the available evidence and expert opinion, could support HCPs in deciding when and how to consider background medication reduction.References Jackson DJ, et al. Lancet. 2024;403(10423):271–81.Global Initiative for Asthma (GINA). 2025 GINA strategy report. https://ginasthma.org/2025-gina-strategy-report/ [Last accessed June 2025]",
  "authors": [
    {
      "affiliations": [
        "Guys Severe Asthma Centre, Guys Hospital, London, UK",
        "School of Immunology and Microbial Sciences, Kings College London, London, UK"
      ],
      "name": "D Jackson"
    },
    {
      "affiliations": [
        "Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK",
        "Royal Liverpool University Hospital, Liverpool, UK"
      ],
      "name": "H Burhan"
    },
    {
      "affiliations": [
        "Hull University Teaching Hospital NHS Trust, Hull, UK"
      ],
      "name": "H Cummings"
    },
    {
      "affiliations": [
        "NHS Tayside, Ninewells Hospital, Dundee, UK"
      ],
      "name": "T Fardon"
    },
    {
      "affiliations": [
        "Queens University Belfast, Belfast, UK"
      ],
      "name": "L Heaney"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "AH Mansur"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "C Owen"
    },
    {
      "affiliations": [
        "Royal Brompton and Harefield hospitals, Uxbridge, UK"
      ],
      "name": "P Patel"
    },
    {
      "affiliations": [
        "University Hospital Southampton NHS Foundation Trust, Southampton, UK"
      ],
      "name": "H Rupani"
    }
  ],
  "title": "P207 Path to consensus: patient and physicians perspectives on reducing background medication in patients with severe asthma controlled on biologic therapy in the UK",
  "uid": "acea123c-a8de-5c52-b2bd-96d9609ccdd0"
}