Background
asthma, exacerbations
ASTHMA
Approximately 5 to 10% of asthma patients have severe or refractory asthma [Advanced therapeutic antibodies (biologics) herald a new era of therapy in patients with severe asthma. Randomized controlled trials (RCTs) have demonstrated that omalizumab (anti-IgE antibody), mepolizumab, reslizumab (anti-interleukin-5 antibodies), benralizumab (anti-IL5Rα antibody), dupilumab (anti-IL4Rα antibody) and tezepelumab (anti-cytokine thymic stromal lymphopoietin antibody) have efficacy in reducing severe exacerbations, improving asthma control and lung function [Indeed, in both clinical trials and real-world settings, individual responses to biologics are heterogeneous even among patients who are pre-selected for enhanced response based on relevant biomarkers and exacerbation history. Previous analyses have shown that 15–17% of biologic users show no response [Combining two international RCTs of mepolizumab in severe asthma, this study aimed to investigate whether salient patient characteristics (including biomarkers) in combination can identify subgroups of patients who may have a better response to therapy. We quantified the heterogeneity of treatment benefit, in terms of reduction in the rate of exacerbations or improvement in symptom control, related to biologic therapy.