{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:47:06Z","timestamp":1792021626092,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This systematic review (SR) aims to delineate the patterns and rationales for biologic switching in patients with severe asthma and evaluate its efficacy across the clinical remission criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The SR followed the PRISMA guidelines (PROSPERO CRD420251155819), with searches up to September 2025. Studies reporting on switching of biologics, including anti\u2010IgE, anti\u2010IL\u20104R\/13R, anti\u2010IL5\/5R, and anti\u2010TSLP, were included. Standardized mean difference (SMD) or mean difference (MD), and pooled relative risk (RR) were calculated for pre\u2010 and post\u2010 switch comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The SR included 49 studies (2292 switched severe asthma patients). The most common switching patterns were mepolizumab\u2010benralizumab (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009637) and omalizumab\u2010mepolizumab\/benralizumab (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009386 or 305, respectively). Additional switching patterns included transitions from other biologicals to dupilumab or tezepelumab. Suboptimal asthma control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091005, 77.0%) was the predominant reason for switching. The switch led to a significant reduction in exacerbations (SMD \u20131.03, 95% CI: \u22121.26 to \u22120.80,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200989%), emergency department visits, hospitalizations, and maintenance oral corticosteroid dose and to improved asthma control ACT MD 5.18 (95% CI 4.32 to 6.04,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200980%), ACQ MD \u20131.05 (95% CI \u20131.26 to \u22120.83,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200945%) and lung function FEV1 MD 0.18\u2009L (95% CI: 0.11 to 0.25,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). T2\u2010biomarkers (blood eosinophils, total serum IgE, FeNO) significantly decreased.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Biologics switching represents a promising strategy supported by high\u2010quality evidence of its clinical efficacy. Switching should consider clinical remission goals, co\u2010morbidities, side effects, costs and reimbursement policies, and patient preferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70333","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T11:19:16Z","timestamp":1775301556000},"page":"1548-1570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Patterns and Clinical Efficacy of Biologics Switching in Patients With Severe Asthma: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"81","author":[{"given":"Yang","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Allergy The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010chun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Allergy 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