{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:11:50Z","timestamp":1787170310333,"version":"build-2736575974"},"reference-count":48,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T00:00:00Z","timestamp":1723507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Indirect comparison among biologics in severe asthma (SA) is a challenging but desirable goal for clinicians in real life. The aim of the study is to define characteristics of a biologic-treated T2-driven-SA population and to evaluate the effectiveness of biologic treatments in a real-world setting by variation in intra\/inter-biologic parameters in an up to 4-year follow-up. Methods: Demographic, clinical, functional, and biological characteristics were evaluated retrospectively in 104 patients recruited until July 2022 at baseline (T0) and over a maximum of 4 years (T4) of biologic therapy (omalizumab\/OmaG = 41, from T0 to T4, mepolizumab\/MepoG = 26, from T0 to T4, benralizumab\/BenraG = 18, from T0 to T2, and dupilumab\/DupiG = 19, from T0 to T1). Variations of parameters using means of paired Delta were assessed. Results: At baseline, patients had high prevalence of T2-driven comorbidities, low asthma control test (ACT mean 17.65 \u00b1 4.41), impaired pulmonary function (FEV1 65 \u00b1 18 %pred), frequent exacerbations\/year (AEs 3.5 \u00b1 3), and OCS dependence (60%). DupiG had lower T2 biomarkers\/comorbidities and AEs, and worse FEV1 (57 \u00b1 19 %pred) compared to other biologics (p &lt; 0.05). All biologics improved ACT, FEV1%, FVC%, AEs rate, and OCS use. FEV1% improved in MepoG and BenraG over the minimal clinically important difference and was sustained over 4 years in OmaG and MepoG. A significant RV reduction in OmaG (T4) and DupiG (T1), and BenraG normalization (T2) of airflow limitation were found. We observed through inter-biologic parameters pair delta variation comparison a significant nocturnal awakenings reduction in BenraG vs. OmaG\/MepoG, and neutrophils reduction in BenraG\/DupiG vs. OmaG. Conclusions: Indirect comparison among biologics unveils clinical and functional improvements that may mark a different effectiveness. These results may highlight the preference of a single biologic compared to another with regard to specific treatable traits.<\/jats:p>","DOI":"10.3390\/jcm13164750","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T06:02:37Z","timestamp":1723528957000},"page":"4750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Biologics in T2 Severe Asthma: Unveiling Different Effectiveness by Real-World Indirect Comparison"],"prefix":"10.3390","volume":"13","author":[{"given":"Elisa","family":"Riccardi","sequence":"first","affiliation":[{"name":"Regional Hospital Parini, Pulmonology Unit, Aosta, 11100 Aosta, Italy"},{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Guida","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"},{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Garino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4390-0394","authenticated-orcid":false,"given":"Francesca","family":"Bertolini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1866-5206","authenticated-orcid":false,"given":"Vitina","family":"Carriero","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Brusamento","sequence":"additional","affiliation":[{"name":"Re Learn S.R.L., 10122 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Pizzimenti","sequence":"additional","affiliation":[{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Giannoccaro","sequence":"additional","affiliation":[{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Falzone","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Arrigo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-7701","authenticated-orcid":false,"given":"Stefano","family":"Levra","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-5018","authenticated-orcid":false,"given":"Fabio Luigi Massimo","family":"Ricciardolo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy"},{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"},{"name":"Institute of Translational Pharmacology, National Research Council (IFT-CNR), Section of Palermo, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1183\/09031936.00202013","article-title":"International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma","volume":"43","author":"Chung","year":"2014","journal-title":"Eur. 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