Background and Importance Despite following adequate treatment, a high percentage of patients with asthma is not controlled; therefore, alternative treatments that are effective and safe are necessary, especially in patients with severe uncontrolled asthma. Among the new treatments for asthma, biological therapy with monoclonal antibodies against selective targets may be a suitable option.

Aim and Objectives To assess the effectiveness and safety in routine clinical practice of omalizumab, mepolizumab and benralizumab in patients with severe uncontrolled asthma.

Material and Methods Retrospective observational study in a regional hospital undergoing patients diagnosed with severe asthma treated with omalizumab, mepolizumab and benralizumab. Effectiveness was assessed based on oral corticosteroid dose reduction, exacerbations and improvement in lung capacity. Safety was demonstrated based on adverse effects onset. Data was obtained from clinical history program and drug dispensing program.

Results 30 patients (53% women) with a median age of 56 years (range: 16–78) have received biological drugs in our hospital to treat severe uncontrolled asthma. 9 patients were treated only with omalizumab, 5 with Mepolizumab, 2 with benralizumab; 7 patients sequentially omalizumab→mepolizumab, 5 cases omalizumab→benralizumab and 2 with the three drugs sequentially.

52% of patients on omalizumab, 71% of patients on mepolizumab, and 78% on benralizumab experienced a decrease in oral corticosteroid dose. Regarding exacerbations: 65% omalizumab, 85% mepolizumab and 78% benralizumab reduced the number of exacerbations. Improvement in lung capacity as a function of Forced Expiratory Volume in 1 second (FEV1) was observed in 74% of patients on omalizumab, 79% on mepolizumab, and 89% on benralizumab. Adverse reactions occurred in 5 cases treated with omalizumab: arthralgia (2), headache, tiredness, cough; 2 cases with benralizumab: skin rash, nasal congestion; and one case of hypertension with the administration of mepolizumab.

Conclusion and Relevance Treatment with omalizumab, mepolizumab and benralizumab in severe asthma is effective in most patients under normal clinical practice conditions. The frequency of adverse effects is low, being mild in most cases, so they can be considered safe drugs.

Conflict of Interest No conflict of interest