Background and Importance Severe uncontrolled eosinophilic asthma (EA) is defined by pulmonary inflammation caused by eosinophilic cells. It is associated with an increased-on cytokine IL-5. Patients diagnosed with this phenotype of asthma are corticoids resistant. Among the new treatments, biological therapy with monoclonal antibodies against IL-5 seems to be a suitable option.

Aim and Objectives Analyze the effectiveness and safety in daily life routine practice with anti IL-5 biological drugs, benralizumab and mepolizumab, used by severe uncontrolled EA patients.

Material and Methods Retrospective observational study in a daily life clinical practice of a third-level hospital. Patients selected diagnosed with EA treated with benralizumab and mepolizumab for at least 12 months from January 2018 to March 2023.

Data was collected from electronic medical records and drug dispensing program: sex, age, Forced Expiratory Volume in 1 second (FEV1), comorbidities, blood eosinophilic count (EOS), Asthma Control Test (ACT), exacerbation’s number, oral glucocorticoid (OCS) based on equivalent doses of prednisone, inhaled treatment. Effectiveness was assessed by the reduction of EOS, OCS and exacerbations; and by the improvement of FEV1 and ACT. Safety profile was demonstrated based on adverse effects (AE) described. The software used for data collection was Microsoft Excel and for statistical analysis JAMOVI.

Results 45 patients were included, 31 women (68.9%), mean age 65.6 years (42–81). 26 patients (57.8%) were treated with benralizumab and 19 (42.2%) with mepolizumab. Most frequent comorbidities presented by patients were: 21 nasal polyposis (46.7%), eight rhinosinusitis (17.8%) and seven Samster’s triad (15.6%). Two patients were smokers (4.4%). After 12 months of treatment FEV1 increased by 20.4% (-18.0–45.5; n=32). 13 patients did not complete the test due to COVID pandemic situation. EOS blood test was reduced by 96.7% (81.8–100.0) from basal level concentrations. Exacerbations’ number presented on the previous year were reduced from 3.75 (0.0–9.0) to 0.5 (0.0–6.0). ACT improved 6.5 points (-6.0–16.0). Only 21 patients (46.7%) required diary OCS, and their dose was reduced to 4.67 mg per day (0.0–30.0). All patients continued inhaled therapy. Any AE were described.

Conclusion and Relevance The use of anti-IL5, benralizumab and mepolizumab, in severe uncontrolled EA patients has shown to be effective and safe on daily life clinical practice, experiencing greater control of asthma.

Conflict of Interest No conflict of interest.