TABLE 2.
Effects on type 2 inflammatory biomarkers, and oral corticosteroid (OCS)-sparing potential, of anti-thymic stromal lymphopoietin (TSLP) and approved biologic therapies for asthma
| Biologic | Effect on inflammatory biomarker | OCS-sparing data | |||
| FeNO | IgE | Blood eosinophils | Sputum eosinophils | ||
| Tezepelumab (anti-TSLP) | ↓ [85, 96, 110] | ↓ [85, 96, 110] | ↓ [85, 96, 110] | ↓ [96] | Data pending (NCT03406078) |
| Dupilumab (anti-IL-4/IL-13) | ↓ [100] | ↓ [100] | ↑ [100] | Insufficient data [112] | ∼70% reduction in daily OCS dosage (versus ∼42% with placebo); 52% of patients achieved complete OCS weaning (placebo, 29%) [113] |
| Omalizumab (anti-IgE) | Minimal effects [114] | ↓ [115] | Minimal effects [116] | ↓ [117] | No RCT data; real-world data indicates reduction in OCS use [118] |
| Mepolizumab (anti-IL-5) | No effect [119] | No effect# | ↓ [119, 120] | ↓ [119, 120] | ∼50% reduction in daily OCS dosage (versus 0% with placebo); 14% of patients achieved complete OCS weaning (placebo, 8%) [121] |
| Reslizumab (anti-IL-5) | No effect¶ | No effect# | ↓ [98, 122] | ↓ [123] | No RCT data; real-world data indicates reduction in OCS use [124] |
| Benralizumab (anti-IL-5Rα) | No effect¶ | No effect# | ↓ [99, 125] | ↓ [125] | ∼75% reduction in daily OCS dosage (versus ∼25% with placebo); 52–56% of patients achieved complete OCS weaning (placebo, 19%) [126] |
FeNO: fractional exhaled nitric oxide; IgE: immunoglobulin E; IL: interleukin; OCS, oral corticosteroid; RCT: randomised controlled trial. #: observed in clinical practice; ¶: expected based on observations with other anti-IL-5 biologics.