Omalizumab leads biologics in reducing exacerbations in severe asthma
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Key takeaways:
- Two-thirds of patients were prescribed omalizumab.
- Exacerbations fell with mepolizumab and dupilumab, but not significantly.
- Most providers did not change their patients’ maintenance medications.
SAN DIEGO — Patients with severe asthma experienced fewer exacerbations with 6 months of treatments with biologics, according to a study presented at the American Thoracic Society International Conference.
Biologic treatment also enabled some patients to de-escalate their maintenance therapy, Sujith Modugula, MD, fellow, Pulmonary-Critical Care Medicine, Allegheny General Hospital, and colleagues wrote.
During a 5-year period, the Allegheny Health Network initiated biologic therapy for 209 patients with severe asthma, including 25 on benralizumab (Fasenra, AstraZeneca), 35 on mepolizumab (Nucala, GSK), 139 on omalizumab (Xolair; Genentech, Novartis) and 10 on dupilumab (Dupixent; Regeneron, Sanofi).
Overall exacerbation rates fell from 1.52 during the 6 months before therapy to 0.83 through the 6 months after therapy (P < .001).
Omalizumab, which accounted for 66% of all prescriptions, saw the largest decrease during this time frame, falling from 1.74 to 0.93 (P < .001). Exacerbations also fell from 1.12 to 0.52 (P < .05) with benralizumab.
Exacerbations also decreased from 1.08 to 0.65 with mepolizumab and from 1.1 to 0.8 with dupilumab, but the researchers did not consider these differences to be significant.
Most providers did not change their patients’ maintenance therapy during the treatment period, although some de-escalated long-acting muscarinic antagonists, discontinued theophylline and other adjunct medications, or reduced inhaled corticosteroid and/or long-acting beta agonist dosages.
The researchers noted that although their study only included 6 months prior to and after initiation of treatment and had a small sample size, their results indicate that biologics can be successful in reducing exacerbations among patients with severe asthma.