TOPLINE:

Tezepelumab yielded the greatest reduction in exacerbations in patients with moderate‑to‑severe allergic asthma, whereas dupilumab yielded superior improvement in lung function, a meta-analysis showed.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 19 randomized controlled trials to evaluate the efficacy of biologics for moderate-to-severe allergic asthma.
• The analysis included 7449 participants aged 12 years or older and compared omalizumab, tezepelumab, dupilumab, and benralizumab with placebo; all biologics were administered as add-on injection therapy to standard medication.
• The primary efficacy outcomes were changes in asthma exacerbation and forced expiratory volume in 1 second (FEV1).
• Secondary outcomes were changes in Asthma Control Questionnaire (ACQ) scores, which reflect asthma symptoms and the frequency of short‑acting beta-2 agonist use, and changes in standardized Asthma Quality of Life Questionnaire + 12 (AQLQ[S] + 12) scores, which indicate functional impairment.

TAKEAWAY:

• A meta‑analysis of 15 trials found that among the biologics evaluated, tezepelumab yielded the greatest reduction in exacerbations compared with placebo (mean difference [MD], -0.81; 95% CI, -1.09 to -0.54).
• Data from nine trials showed superior improvement in FEV1 in patients receiving dupilumab than in those receiving placebo (MD, 0.16; 95% CI, 0.07-0.24).
• Analysis of data from eight trials demonstrated a decline in ACQ scores in patients receiving omalizumab (MD, -0.49; 95% CI, -0.89 to -0.08) or dupilumab (MD, -0.40; 95% CI, -0.77 to -0.04) compared with placebo.
• In an analysis of nine trials, patients receiving omalizumab showed a significant increase in AQLQ[S] + 12 scores compared with placebo (MD, 0.62; 95% CI, 0.21-1.03).

IN PRACTICE:

“Considering its significant clinical advantages in reducing exacerbations and improving lung function, tezepelumab should be prioritized as a treatment option for moderate-to-severe allergic asthma,” the authors wrote.

SOURCE:

Xianming Fan, with the Southwest Medical University in Sichuan, China, was the corresponding author of the study, which was published online on October 30, 2025, in International Archives of Allergy and Immunology. 

LIMITATIONS:

The absence of head‑to‑head trials among biologics, the limited and underpowered benralizumab studies, and the lack of eligible randomized controlled trials for mepolizumab and reslizumab limited the comprehensiveness of the network meta‑analysis.

DISCLOSURES:

The authors declared having no conflicts of interest.

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