Abstract
Background
In Europe, despite approval of multiple biologics for the treatment of severe asthma (SA), comparative data from real-world settings are limited. This study compared the real-world effectiveness of dupilumab with that of omalizumab, benralizumab and mepolizumab in European patients with SA.
Methods
In EU-ADVANTAGE, physicians from France, Italy, Germany, Spain and the Netherlands were recruited to retrospectively review medical charts of patients (aged ?12?years) who had physician-confirmed SA and initiated dupilumab, omalizumab, benralizumab or mepolizumab (index) between May 2019 and February 2022. Patients with ?12?months of pre- and post-index records were included. Differences in baseline covariates were balanced with inverse probability of treatment weighting (IPTW) between dupilumab and other biologics. Reductions in SA exacerbations and oral corticosteroid (OCS) prescriptions during 12 months post-index period were estimated using a doubly robust regression.
Results
Of the 2739 patients included, 1281, 638, 406 and 414 received dupilumab, omalizumab, benralizumab and mepolizumab, respectively. After IPTW, the differences were balanced (standardised difference <10%) for majority of the baseline covariates between dupilumab and other biologics. The doubly robust regression model found dupilumab to be associated with a lower risk of SA exacerbations during the 12-month post-index period: 22% versus omalizumab, 35% versus benralizumab and 23% versus mepolizumab. Additionally, dupilumab significantly reduced OCS prescriptions by 25% versus omalizumab, 27% versus benralizumab and 21% versus mepolizumab.
Conclusions
The findings suggest that dupilumab is more effective in reducing exacerbations and OCS use in patients with SA than omalizumab, benralizumab and mepolizumab in European real-world settings.
