Depemokimab shows no significant difference from other biologics in reducing severe asthma exacerbationsDepemokimab Shows Similar Results to Other Biologics for Severe Asthma

BACKGROUND: Depemokimab is the first ultra-long-acting biologic, with efficacy and safety recently reported in the Phase III SWIFT-1/-2 studies, which included patients with type 2 asthma. OBJECTIVE: To estimate the relative efficacy and safety of depemokimab vs other biologics via an indirect treatment comparison. METHODS: The indirect treatment comparison evidence base was compiled via a systematic literature review to identify randomized clinical trials on the efficacy and safety of biologics in patients with severe asthma. End points were analyzed using network meta-analysis (unadjusted) and multi-level network meta-regression (partially or fully adjusted for clinically relevant or statistically feasible covariates, including prior exacerbation history, inhaled or oral corticosteroid use, and blood eosinophil count) and included annualized exacerbation rates (AERs), adverse events (AEs), and serious AEs (SAEs). RESULTS: Overall, 17 and 22 trials were included in the exacerbation and safety analyses, respectively. Significant differences in efficacy were observed in the unadjusted fixed-effect model for depemokimab vs placebo, omalizumab, benralizumab, and dupilumab 300 mg and in the partially adjusted fixed-effect model for depemokimab vs placebo and omalizumab. In the fully adjusted fixed-effect model, depemokimab significantly reduced AERs vs placebo; no significant differences were observed between depemokimab and other biologics in this model. The odds of experiencing AEs and SAEs were similar across treatments, with fewer SAEs observed with depemokimab than with dupilumab. The results were generally consistent across fixed- and random-effect approaches. CONCLUSION: In general, no statistically significant difference was detected between depemokimab and other biologics in terms of AER reduction or safety in severe asthma, including when adjusting for differences across studies in clinically important patient characteristics.