Comparative effectiveness of Anti-IL5 and Anti-IgE biologic classes in severe asthma patients eligible for both

David Price* (Corresponding Author), paul pfeffer, Nasloon Ali, Ruth Murray, Charlotte Ulrik, Trung Tran, Jorge Maspero, Matthew Peters, George Christoff, Mohsen Sadatsafavi, Carlos A. Torres-Duque, Alan Altraja, Lauri Lehtimäki, Nikolaos Papadopoulos, Sundeep Salvi, Richard W. Costello, Breda Cushen, Enrico Heffler, Takashi Iwanaga, Mona Al-AhmadDésirée Larenas-Linnemann, Piotr Kuna, João Fonseca, Riyad Al-Lehebi, Chin Kook Rhee, Luis Perez de Llano, Diahn-Wang Perng, Bassam Mahboub, Eileen Wang, Yun Yi Celine Goh, Juntao Lyu, Anthony Newell, Marianna Alacqua, Mohit Bhutani, Leif Bjermer, Unnur Steina Björnsdóttir, Arnaud Bourdin, Anna Von Bülow, John Busby, Walter Canonica, Borja G Cosio, Delbert Dorscheid, Mariana Muñoz Esquerre, Mark FitzGerald, Esther Garcia Gil, Peter Gerard Gibson, Liam Heaney, Mark Hew, Ole Hilberg, Flavia Hoyte, David Jackson, Mariko Koh, Hsin-Kuo Ko, Jae Ha Lee, Sverre Lehmann, Claudia Chaves Loureiro, Dora Ludviksdottir, Andrew Menzies-Gow, Patrick Mitchell, Andriana Papaioannou, Todor Popov, Celeste Porsbjerg, Laila Salameh, Concetta Sirena, Camille Taillé, Christian Taube, Yuji Tohda, M. E. Wechsler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life.
This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term366 oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance and hospital admissions.
In the matched analysis (n=350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p372 experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs 20.55% reduction; p=0.023).) There was some evidence to suggest that patients treated with anti374 IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43).
In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes, however anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.
Original languageEnglish
Publication statusAccepted/In press - 23 Dec 2022


  • biologics
  • exacerbation
  • ISAR
  • real life
  • oral corticosteroids


Dive into the research topics of 'Comparative effectiveness of Anti-IL5 and Anti-IgE biologic classes in severe asthma patients eligible for both'. Together they form a unique fingerprint.

Cite this