Effectiveness of biological therapy in severe asthma: a retrospective real-world study.

UNLABELLED: Aim- To compare the effectiveness of different biologic medications for the treatment of severe asthma.

METHODS

We retrospectively collected data on 74 patients treated with one of four different biologics (omalizumab, mepolizumab, reslizumab, or benralizumab) at the Jordanovac Clinic for Pulmonary Diseases, Zagreb, Croatia for at least two years. The patients were compared in terms of the number of exacerbations, dose of oral corticosteroids (OCS), asthma control test (ACT), forced expiratory volume in 1 second (FEV1), forced vital capacity, fraction of exhaled nitric oxide (FeNO), number of blood eosinophils, and total immunoglobulin E (IgE).

RESULTS

All treatment outcome measures, except FeNO, significantly improved in the two-year period (P<0.001). The number of acute exacerbations decreased in all groups. Reslizumab-treated patients showed the greatest improvement in ACT score, and the omalizumab-treated patients experienced the least (P=0.018). The benralizumab group showed the greatest reduction in eosinophil number, and the omalizumab group the lowest (P<0.001). The mepolizumab group showed the greatest improvement in FEV1.

CONCLUSION

Both anti-IgE and anti-IL-5 treatments effectively reduced exacerbation rates, OCS daily needs, and symptom burden. Multiple predictive biomarkers are needed for the best individual monitoring.