Quality of life and work functionality in severe asthma patients: the impact of biological therapies

Background Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. Methods Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively. Results Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 +/- 12 vs.87 +/- 13%; 72 +/- 14 vs. 86 +/- 14%), FVC% (92 +/- 11 vs. 101 +/- 11%; 90 +/- 13 vs. 98 +/- 14%) and FEV1/FVC (62 +/- 11 vs. 71 +/- 8%; 64 +/- 9 vs. 70 +/- 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 +/- 10.3 and 48.5 +/- 8.5 to 46.8 +/- 8.6 and 51.6 +/- 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 +/- 6 vs. 40 +/- 6, P = 0.001). A significant reduction in the absenteeism (19 +/- 15 vs. 3 +/- 11%; P < 0.001) and presenteeism rate (53 +/- 24 vs. 29 +/- 26%; P < 0.001), and an improvement in daily (40 +/- 27.5% vs. 28.9 +/- 24.7%, P < 0.001, in the overall population) and work activities (57 +/- 25 vs. 29 +/- 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. Conclusions Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.