Mepolizumab and tezepelumab were associated with the greatest reductions in asthma exacerbations among patients with moderate to severe, uncontrolled asthma with nasal polyps, when compared with placebo, according to results presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2024 Annual Meeting, held from February 23 to 26 in Washington, DC.
To identify data for inclusion, the study investigators conducted a systematic literature search in PubMed and Cochrane for randomized, placebo-controlled phase 3 trials that reported on the use of biologic treatments for moderate to severe, uncontrolled asthma in patients with a history of comorbid nasal polyps. Data from 4 Food and Drug Administration-approved biologics were included in the analysis: mepolizumab, benralizumab, dupilumab, and tezepelumab.
Compared with placebo, findings showed annualized asthma exacerbations (AAER) were reduced by 86% with tezepelumab over 52 weeks (rate ratio, 0.14 [95% CI, 0.07-0.30]), 80% with mepolizumab over 24 weeks (rate ratio, 0.20, 95% CI, 0.11-0.35), 69% with benralizumab over 24 weeks (rate ratio, 0.31 [95% CI, 0.19-0.50]) and 67% with dupilumab over 52 weeks (rate ratio, 0.33; combined data from 200mg and 300mg dosing groups).
Improvements in the Sino-Nasal Outcome Test (SNOT)-22 scores were found to be similar across the biologic therapies: mepolizumab: -11.8 (95% CI, -19.8, -3.9); benralizumab: -8.9 (95% CI, -16.4, -1.4); dupilumab 200mg: -11.9 (95% CI, -17.6, -6.2); dupilumab 300mg: -10.3 (95% CI, -15.8, -4.9), tezepelumab: -11.1 (95% CI, -17.8, -4.4).
Based on these findings, the study authors concluded that, “mepolizumab and tezepelumab demonstrated the greatest reductions in asthma exacerbations vs placebo over 24 and 52 weeks, respectively. Improvements in SNOT-22 scores were similar across biologics.” They noted that additional research would be needed to confirm these findings as the comparisons were limited by different study designs and patient populations.
Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on MPR.
