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Abstract
(en) BACKGROUND: Different biologics available as an add-on treatment for severe asthma (SA) demonstrated modest benefits on lung function parameters, but head-to-head comparisons are lacking. OBJECTIVE: To compare the effects of 4 biologics on lung function parameters (including small airways) at 6 and 12 months of treatment in patients with SA. METHODS: An observational multicenter study was conducted on adult patients with SA naive to biologics treated by benralizumab, dupilumab, mepolizumab, and omalizumab with lung function assessment by spirometry and gas dilution method at baseline, after 6 months (T6), and after 12 months of treatment. RESULTS: A total of 158 included patients were divided into the following 4 groups: 41 patients treated with omalizumab, 41 patients with mepolizumab, 36 patients with benralizumab, and 40 patients with dupilumab. Most lung function parameters were improved after 6 and 12 months of treatment without significant differences between groups except for the changes in the forced expiratory volume in 1 second in percentage (5.8 ± 15.2 vs 10.3 ± 10.8 vs 14.3 ± 15.3 vs 11.8 ± 14.6, P = .025) and forced vital capacity in percentage (3.0 ± 15.6 vs 6.7 ± 14.6 vs 13.6 ± 14.7 vs 8.4 ± 14.9, P = .014) at T6, which were higher in the group receiving benralizumab. Trends for greater effectiveness of dupilumab in improving small airway dysfunction and of benralizumab on distal airway obstruction were noted, but the results were not always significant. CONCLUSION: All 4 biologics demonstrated comparable effectiveness in the improvement of lung function parameters after 6 and 12 months of treatment, except for the changes in the forced expiratory volume in 1 second and the forced vital capacity in percentage at T6, which were in favor of benralizumab.
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Tiotiu-Cepuc, I., Pilette, C., Bagnasco, D., Bondi, B., Braido, F., & Liistro, G. (2025). Comparative analysis of biologics’ effects on lung function parameters in severe asthma. Annals of Allergy, Asthma & Immunology, 135(6), 653-662. https://doi.org/10.1016/j.anai.2025.09.002 (Original work published 2025)