A real life asthma biologic treatment comparison

Introduction: Biologic drugs have proven to be highly effective in managing severe asthma, improving quality of life, and reducing exacerbations. Material and methods: We compared the efficacy of omalizumab, mepolizumab, and dupilumab in patients with severe asthma on active pharmacological treatment. Results: Forty-nine patients with a mean age of 49 years were analyzed, 53.1% women and 46.9% men. 22.4% were ex-smokers compared to 8.2% active smokers. Notable medical history included atopy (42.9%), polyposis (38.8%), sensitization to olive pollen (38.8%), AERD (22.4%), drug allergy (16.3%), and mental health history (10.2%). Regarding the severe asthma phenotype, they presented a T2 allergic phenotype (57.1%), high T2 (34.7%), and non-T2 (8.2%). It was observed that in all biological drugs, the need to go to the emergency room and the use of oral glucocorticoids was reduced by half in the two years after their administration. We obtained a naive subgroup of 38 patients without previous biological treatment. The improvement is notable in terms of a lower number of visits to the emergency room and cycles of systemic corticosteroids in the first year of treatment. Improvement in the percentage of FEV1 after one year of treatment in the three groups, but only in a statistically significant way in the Dupilumab treatment group. Conclusion: Clinical improvement is observed in patients with severe asthma after one year of treatment with different biological drugs, although statistical significance is only obtained in the improvement of functional capacity in the Dupilumab treatment group.