ArticleScientific reports2026
Relationship between knowledge, adherence-related behaviors and self-management with response to monoclonal antibody therapy in patients with severe asthma.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study explores the relationship between patient activation, adherence behaviors, asthma knowledge, and response to monoclonal antibody (mAb) therapy in severe eosinophilic asthma (SEA). Despite advances in mAb therapies, some SEA patients continue to experience uncontrolled symptoms. Understanding these factors could lead to more effective, personalized treatment strategies. Participants diagnosed with SEA and undergoing mAb therapy for 6-9 months were recruited from three German university outpatient clinics. They were categorized using the Biologics Asthma Response Score (BARS) into responders, partial responders, and non-responders. Data collection focused on demographic details, lung function, medication history, patient activation (PAM13-D), and adherence (A14 questionnaire). Statistical analyses assessed the impact of adherence and knowledge on treatment outcomes. Of the 140 participants, 61% were responders, 24% partial responders, and 15% non-responders. Age, sex distribution, smoking status, pack-years, eosinophil levels, ExNO and lung function parameters were comparable across response groups. A14 scores and asthma knowledge differed significantly across response groups, whereas PAM13-D did not. In ordinal logistic regression, asthma knowledge remained associated with BARS-defined response category after adjustment. A negative attitude towards drugs was associated with response category in univariate analysis, but this association was attenuated after adjustment. Better asthma knowledge was associated with BARS-defined response to mAb therapy, while PAM13-D and overall A14 score were not independently associated with response. Medication attitude may still be clinically relevant, but their association with response should be interpreted cautiously. These findings support a patient-centered approach that considers asthma knowledge, adherence-related behaviors and medication attitudes during biologic treatment. Prospective studies are needed to determine whether targeted education and adherence support can improve clinical outcomes.
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