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Title: Clinical and Lung Function Outcomes After Anti-IgE or Anti-IL5 Therapy in Severe Asthma.
Austin Authors: AlShareef, Saad;McDonald, Christine F ;Lee, Joy 
Affiliation: School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia..
Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 13317-4233, Saudi Arabia..
Respiratory and Sleep Medicine
Institute for Breathing and Sleep
Faculty of Medicine, University of Melbourne, Melbourne, Australia..
Issue Date: 15-Feb-2022
Date: 2022
Publication information: Journal of asthma and allergy 2022; 15: 209-217
Abstract: Although there have been indirect comparisons of the relative efficacy of mepolizumab (anti-IL-5) and benralizumab (anti-IL-5Rα) in severe asthma patients, long-term direct head-to-head comparisons are lacking. Here, we (i) examined the effect of mepolizumab, benralizumab, and omalizumab on symptom control and lung function parameters over time; and (ii) compared the efficacy of mepolizumab and benralizumab on symptom control and lung function outcomes. This was a retrospective study of patients with severe asthma taking anti-IgE (omalizumab; n = 24), anti-IL5 (mepolizumab, n = 23), or anti-IL-Rα (benralizumab; n = 12) therapy. Data were extracted on (i) Asthma Control Questionnaire (ACQ-5) scores; (ii) forced expiratory volume over 1 second (FEV1); and (iii) peak expiratory flow rate (PEFR) at 4-6 months and 1 year and documented reductions in exacerbations. Clinical and lung function outcomes were compared between patients taking mepolizumab and benralizumab and over time. There were significant decreases in ACQ-5 scores (3.3 ± 0.93 to 1.7 ± 0.98 for mepolizumab, 3.5 ± 0.72 to 1.6 ±0.89 for benralizumab, and 3.5 ± 0.95 to 1.7 ± 1.1 for omalizumab; t-test, all p < 0.0001) but not increases in FEV1 and PEFR for all three agents after 4-6 months of therapy, which persisted but did not decrease further at one year. There were trends toward a greater percentage increase in FEV1 and PEFR from baseline and a decrease in the number of exacerbations in patients taking benralizumab than those taking mepolizumab. Although limited by a small sample size, this real-world, head-to-head comparison of mepolizumab and benralizumab is consistent with comparative data on asthma biologicals and indirect comparisons showing no major difference in efficacy. The study also generates new testable hypotheses about the efficacy of asthma biologicals in different patient populations.
DOI: 10.2147/JAA.S348137
ORCID: 0000-0002-0104-6583
Journal: Journal of asthma and allergy
PubMed URL: 35210787
PubMed URL:
ISSN: 1178-6965
Type: Journal Article
Subjects: asthma
monoclonal antibody
Appears in Collections:Journal articles

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