Background:

Severe asthma (uncontrolled despite optimal therapy (Chung, K.F., et al., 2014)) can be treated with biologic agents targeting specific molecules causing type-2 inflammation.

The study compares Mepolizumab and Dupilumab for treating severe eosinophilic or type-2 high asthma in patients naïve to biologics. The aim is to see the impact on lung function, inflammation markers, and asthma control.

Methods:

We report data on biologic-naïve patients with severe eosinophilic or type-2 high asthma treated with Mepolizumab or Dupilumab at Aarhus University Hospital in Denmark. 

Retrospective real-life data on lung function, inflammatory markers and asthma control was used, extracted from the Danish Severe Asthma Registry (DSAR). Data from baseline visits and 4-month controls was analyzed using relevant statistical tools.

Results:

Dupilumab improved lung function, with a mean 14.5% improvement in FEV1% predicted (p<0.0001), whereas Mepolizumab did not significantly affect FEV1% predicted.

Dupilumab reduced the median FeNO from 34 ppb to 15 (p<0.005). Mepolizumab increased median FeNO from 36 ppb to 42,5 (p=0,2).

Mepolizumab lowered median blood eosinophilia from 0,37*10?cells/L to 0,07 (p<0,001), whereas Dupilumab lowered median blood eosinophilia from 0,61*10?cells/L to 0,5 (p=0,865).

Both drugs improved QoL measured by the ACQ, with Dupilumab having a greater effect.

Conclusion:

We found a difference in the effects on lung function, inflammation, and asthma control between Mepolizumab and Dupilumab, when administered to severe T2-inflammatory asthma patients, 4 months after initiation of therapy.