Background
When treating patients with severe asthma there is an increasing number of highly specific monoclonal antibodies(biologics) available.
The decision of which biologic to use depends on the patientŽs endotype, economic preferences and local experience with the drug.
In this study we compare 2 biologics benralizumab and mepolizumab regarding the efficacy, effect on ACQ, FEV1 and on the number of asthma exacerbations
 
Methods
We conducted a retrospective study of all patients treated with benralizumab and mepolizumab with minimum one year of follow-up.

None of the patients had previous been treated with a biologic for their asthma.
 
ACQ, FeNO, blood-eosinphils, FEV1 and number of exacerbations were recorded at baseline, 4 months- and 1 year of follow-up.

Results
Between 2016 and 2022 16 patients and 22 patients with a median age of 61(25-77) and 58(17-79) years were treated with benralizumab and mepolizumab, respectively.

Benralizumab: from baseline to one-year follow up ACQ was reduced from 2,67(1,83-3,83) to 0,94(0,17-2,5), FeNO from 45,8(5-145) to 24,5(9-64) ppb, blood-eos from 0,45(0,01-2,19) to 0,01(0-0,03) x10E9/L, the number of exacerbations from 2,13(0-6) to 0,36(0-3).

Mepolizumab: from baseline to one-year follow up ACQ was reduced from 2,31(0,5-3) to 0,79(0-2,67), FeNO from 48,8(7-176) to 40,1(2-185) ppb, blood-eos from 0,52(0,06-1,5) to 0,05(0,02-0,09) x10E9/L, the number of exacerbations from 2,68(0-9) to 0,45(0-4).

FEV1 showed no significant variation.

Conclusions
Both biologics resulted in comparable improvement in asthma control and inflammation markers and a significant reduction in the number of asthma exacerbations.