Table 2.
Omalizumab | Mepolizumab | Reslizumab | Benralizumab | Dupilumab | Tezepelumab ¶ | |
Biomarkers associated with reduction in exacerbation rate | ||||||
Blood eosinophils, cells·μL−1 | ≥260# | ≥300 | ≥400 | ≥300 | ≥300 | ≥150 |
FENO, ppb | ≥19.5 | Not associated | Not associated | Not associated | ≥25 | ≥25 |
Outcomes | ||||||
Exacerbation rate reduction+ | 25%§ | ∼50% | ∼40% | ∼50% | ∼70% | ∼70% |
mOCS reduction | ++ | ++ | ++ | |||
Quality of life improvement | + | + | + | + | + | ++ |
FEV1 improvementƒ | +/− | + | +/− | + | ++ | ++ |
Treatment of comorbidities | ||||||
CRwNP## | ++ | ++ | + | ++¶¶ | ||
Atopic dermatitis | ++ | |||||
Chronic urticaria | + | |||||
EGPA | ++ | + | + | |||
Practical considerations | ||||||
Frequency | 2–4 weekly | 4 weekly | 4 weekly | 8 weekly | 2 weekly | 4 weekly |
Route | s.c. variable dose++ | s.c. fixed dose | i.v. | s.c. fixed dose | s.c. fixed dose | s.c. fixed dose |
Where possible, information in this table relates to phase 3 trial populations with blood eosinophils ≥300 cells·μL−1 and using current licensed doses. Quality of life relates to AQLQ only. #: see Hanania et al. [25]. ¶: the data presented relate to the subgroup with blood eosinophils ≥300 cells·μL−1; this population had ≥3 exacerbations in the previous 12 months, which is higher than the other phase 3 studies. +: exacerbation rate is difficult to compare across biologics due to differing study populations (e.g. moderate-to-severe asthma), different inclusion criteria (e.g. eosinophil count threshold) and size of placebo responses. §: see Normansell et al. [11]. ƒ: FEV1 improvement: +/− indicates unclear or inconsistent results; + indicates improvement of ∼100 mL to <200 mL; ++ indicates improvement of ≥200 mL. ##: for CRwNP: + indicates significant improvement in SNOT-22 score or severity of disease; ++ indicates improvement in both. ¶¶: improvement with dupilumab larger magnitude than with mepolizumab/omalizumab. ++: this may result in more than one injection to achieve the correct dose.