According to a recent study, anti-IL-5/IL-5-R therapies had generally comparable clinical outcomes in severe patients with and without fungal sensitisation, suggesting the clinical effectiveness of treatments targeting IL-5 in patients with severe eosinophilic asthma regardless of fungal sensitisation status. This data is available online at ATS 2020 International Conference site.

Until now, there has been limited data on clinical outcomes in patients with severe asthma and fungal sensitisation (SAFS) treated with biologic therapies targeting IL-5/IL-5R. Treatment options are usually oral corticosteroids and anti-fungal therapies.

This single-center retrospective analysis recruited severe asthma patients with and without fungal sensitisation. From 2018-2019, patients were treated with mepolizumab or benralizumab for at least 48 weeks. 

In total, 154 patients were treated with mepolizumab (n=86) or benralizumab (n=68). There was a higher number of patients without fungal sensitisation (n=129) than patients with SAFS (n=25). Baseline disease characteristics were comparable between the groups, with the exception of baseline mean±SEM IgE (975.5±169.4 kU/L in the SAFS group vs 387.8±58.2 kU/L in group without FS; P<0.0001). The mean age was 53 years and 69 patients were male. 

Overall, treatment with either mepolizumab or benralizumab significantly reduced exacerbation rate, eosinophil count, and OCS dose in patients with SAFS and without fungal sensitisation (all P<0.05). Significant improvement in the Asthma Control Questionnaire (ACQ) scores were observed in patients without fungal sensitisation (P<0.05). There were no clinically meaningful changes in FEV1 overall or when stratified by fungal sensitisation status.