Effectiveness of dupilumab vs omalizumab in patients with severe asthma – The EU-ADVANTAGE study

<bold>Background:</bold> In Europe, dupilumab is approved for severe asthma (SA) with a type 2 inflammation and omalizumab in indicated for allergic asthma; yet real-world comparative effectiveness data are limited. <bold>Objective:</bold> To compare the real-world effectiveness of dupilumab and omalizumab in European patients with SA. <bold>Methods:</bold> Physicians from 5 European countries retrospectively reviewed medical charts of patients (aged ≥12 years) who had physician-confirmed SA, initiated dupilumab or omalizumab treatment between May 2019–Feb 2022 (index) and had ≥12 months of pre- and post-index data. Difference in baseline covariates were balanced with inverse probability of treatment weighting (IPTW). Asthma exacerbations and oral corticosteroid (OCS) prescriptions during the 12-months post-index were estimated using a doubly robust regression. <bold>Results:</bold> Dupilumab and omalizumab cohorts included 1281 and 638 patients, respectively. The majority of baseline characteristics were balanced after IPTW (standardised difference <10%). Compared with omalizumab, dupilumab cohort showed a significantly (<italic>p</italic><0.05) greater reduction in rate of asthma exacerbations (22%) and OCS prescriptions (25%) (<bold>Fig</bold>). <bold>Conclusion:</bold> In this retrospective chart review, dupilumab appeared to be more effective in patients with SA than omalizumab. The results may aid clinical decision-making; however, residual confounding may exist due to unmeasured clinical characteristics. <fig><object-id>erj;64/suppl_68/PA2171/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>