Real-Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps

Clin Rev Allergy Immunol. 2023 Apr;64(2):179-192. doi: 10.1007/s12016-022-08938-w. Epub 2022 Apr 14.


Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.

Keywords: Biological therapies; Comparative analysis; Effectiveness; Nasal polyposis; Severe allergic asthma.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Anti-Asthmatic Agents* / therapeutic use
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Asthma* / complications
  • Asthma* / drug therapy
  • Humans
  • Nasal Polyps* / complications
  • Nasal Polyps* / drug therapy
  • Omalizumab / therapeutic use
  • Retrospective Studies


  • Anti-Asthmatic Agents
  • benralizumab
  • mepolizumab
  • Omalizumab
  • Antibodies, Monoclonal, Humanized