Summary

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• This summary is based on the review of 31 systematic review(s)/meta-analysis(es). ^[1-31]
• In patients with asthma, mepolizumab reduced annualized asthma exacerbation rates by 56% for exacerbations requiring hospitalization or emergency department (ED) visits; in an Italian real-world cohort, clinically significant exacerbations decreased from 3.74 to 0.67 clinically significant exacerbations (CSEs)/patient/year.
• Dupilumab reduced asthma exacerbations more effectively than mepolizumab (relative risk (RR) 0.74 \[95% confidence interval (CI) 0.62 to 0.89]); benralizumab and reslizumab showed inconsistent efficacy in reducing annualized asthma exacerbation rate (AAER).
• In asthma populations, mepolizumab significantly improved Asthma Control Test (ACT) scores and showed variable forced expiratory volume in one second (FEV1) improvement, particularly in those with higher eosinophil counts; dupilumab generally produced greater lung function and quality of life improvements.
• For patients with chronic rhinosinusitis with nasal polyps (CRSwNP), mepolizumab significantly improved nasal polyp score and 22-item Sinonasal Outcome Test (SNOT-22) scores in real-world settings; dupilumab demonstrated superior efficacy, while omalizumab was less effective than dupilumab.
• Mepolizumab was generally well-tolerated with low discontinuation rates due to adverse events; commonly reported adverse events included headache and injection site reactions.
• Dupilumab showed a higher incidence of injection-site reactions compared to placebo and lower discontinuation rates due to adverse events compared to benralizumab.
• Benralizumab had a higher incidence of antidrug antibodies than other biologics and a higher risk of serious adverse events leading to discontinuation compared to placebo.
• Mepolizumab was particularly effective in patients with severe eosinophilic asthma, showed consistent benefits in real-world chronic rhinosinusitis with nasal polyps (CRSwNP) populations, and demonstrated limited efficacy in eosinophilic chronic obstructive pulmonary disease (COPD); in comparison, dupilumab and tezepelumab showed greater efficacy in patients with higher eosinophil counts for asthma, while dupilumab showed superior outcomes in CRSwNP and eosinophilic COPD subgroups.