TOPLINE:

Among patients with severe asthma, treatment with dupilumab yielded greater improvements in percent predicted forced expiratory volume in 1 second (FEV₁) over 12 months than treatment with omalizumab, benralizumab, or mepolizumab.

METHODOLOGY:

• In a retrospective chart review study, researchers assessed the effectiveness of dupilumab vs omalizumab, benralizumab, or mepolizumab in improving lung function in patients with severe asthma.
• They analyzed data from 845 patients with prebronchodilator percent predicted FEV₁ (prebronchodilator group) and 557 patients with postbronchodilator percent predicted FEV₁ (postbronchodilator group), all aged 12 years or older, across five European Union countries between May 2019 and February 2022.
• They performed pairwise comparisons (dupilumab vs each comparator) using inverse probability of treatment weighting to balance baseline covariates.
• The Global Lung Function Initiative online calculator — a tool used to interpret lung function values — was used to calculate percent predicted FEV₁ values from recorded FEV₁ measurements and demographic data.
• The effectiveness outcome was the amount of change in percent predicted FEV₁ over the 12 months after biologic initiation, assessed separately in the prebronchodilator and postbronchodilator groups.

TAKEAWAY:

• In the prebronchodilator group, the mean change in percent predicted FEV₁ was greater in patients receiving dupilumab than in those receiving omalizumab (15.2 vs 9.8), benralizumab (16.0 vs 12.1), or mepolizumab (15.4 vs 9.8).
• Similarly, in the postbronchodilator group, the mean change in percent predicted FEV₁ was greater in patients receiving dupilumab than in those receiving omalizumab (14.3 vs 6.9), benralizumab (14.6 vs 9.2), or mepolizumab (14.2 vs 1.6).
• After 12 months of treatment in the prebronchodilator group, 22.4% of dupilumab-treated patients with baseline percent predicted FEV₁ ≤ 80% achieved percent predicted FEV₁ > 80%. In contrast, 12.5% of patients treated with omalizumab, 18.5% with benralizumab, and 27.4% with mepolizumab achieved this improvement.
• In the postbronchodilator group, the proportion of patients achieving improvement with dupilumab was approximately twice that observed with omalizumab, benralizumab, or mepolizumab.

IN PRACTICE:

“These findings may help clinicians select appropriate biologics for improving lung function in patients with SA [severe asthma],” the authors of the study wrote.

SOURCE:

The study was led by Arnaud Bourdin, MD, PhD, University of Montpellier, Montpellier, France. It was published online on February 4, 2026, in Respiratory Research.

LIMITATIONS:

The study was limited by potential selection bias due to variation in clinician experience and patient phenotypes, nonstandardized FEV₁ measurements across physicians, a 12-month follow-up period that precluded the assessment of long-term lung function durability, and limited generalizability outside European healthcare settings.

DISCLOSURES:

The study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Four authors reported being employees of Sanofi, and two authors reported being employees of Regeneron Pharmaceuticals. Several authors reported receiving research grants or honoraria and/or fees for lectures or advisory board participation, acting as investigators/coinvestigators, or serving as consultants or advisory committee members for various pharmaceutical companies. Additionally, two authors reported being employees of Analysis Group, Inc. (which received research funds from Sanofi), and one author reported being a paid consultant to Sanofi.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.