Efficacy comparisons of biologic therapies for asthma in adults: a real-life study

<bold>Background:</bold> Several biologic treatments are available for asthma patients who are not well controlled with inhaled corticosteroids (ICS) and bronchodilators. Anti-IgE (omalizumab) and anti-IL-5 (mepolizumab, dupilumab, omalizumab and reslizumab). Real-life studies that compare the effectiveness of add-on biologic treatment are lacking. <bold>Methods:</bold> The study population were adult asthma patients who treated with omalizumab and mepolizumab for asthma alone. The number of systemic steroids (injectable and oral) and the number of ICS purchases were compered between 12 months before the first biological treatment and 12 months after. <bold>Results:</bold> Of the 173 patients, 122 were treated with omalizumab and 51 with mepolizumab. There was no significant difference in the mean age between the two groups. Higher proportion of females received mepolizumab than omalizumab (75% vs. 57%, p = 0.0339). Omalizumab significantly reduces the number of patients who purchases steroid tablets from 34% to 20% (p < 0.001) but not mepolizumab. No significant differences were found in the number of patients who purchased steroid tablets or inhalers between the year before and during the biological treatments for both drugs. For both drugs, no significant differences were found in the mean number of steroid injections, tablets and inhaler purchase during the year of biological treatments among patients who purchased them at a year before. <bold>Conclusion:</bold> Omalizumab in this study was superior to mepolizumab in reducing the number of patients who were treated with steroid injections. This call for randomized control trail to further explore the effectiveness of different biological treatments in asthma.