Depemokimab is comparable in efficacy and safety to all other severe asthma biologics, with advantage of 6-month dosing

Severe asthma affects 13-26 million people worldwide. We now have 6 biologics, but many require injections every 2-8 weeks and we've never had a head-to-head trial of the newest one.

In the September 2026 Annals of Allergy, Asthma & Immunology, Bourdin et al. (p329-339) address this with an indirect treatment comparison of depemokimab.

What is it?

Depemokimab is the first ultra-long-acting anti-IL-5 biologic - engineered for high potency and extended half-life, dosed twice yearly. Efficacy was shown in SWIFT-1 and SWIFT-2.

Why an indirect comparison?

No trial randomizes depemokimab vs mepolizumab vs benralizumab vs dupilumab vs tezepelumab vs omalizumab. Trials from 2003-2025 also enrolled very different populations. The authors did a systematic review (Embase, MEDLINE, Cochrane) - 17 trials for exacerbations, 22 for safety - and used both standard network meta-analysis and multilevel network meta-regression adjusting for prior exacerbation history, ICS/OCS use, and eosinophil count.

What they found:

Unadjusted model: depemokimab better than placebo, omalizumab, benralizumab, dupilumab 300mg

Fully adjusted model (most relevant): depemokimab significantly reduced annualized exacerbation rates vs placebo, with no significant difference vs any other biologic

Safety: odds of AEs and SAEs similar across biologics, with fewer SAEs than dupilumab in this analysis

What it means:

For severe type 2 asthma, twice-yearly dosing appears to deliver the same exacerbation reduction as biologics given 6-26 times per year. That has major implications for adherence, access, and quality of life.

Limitations: ITC is not a head-to-head trial, and this analysis focused on exacerbations, not lung function, OCS sparing, or non-T2 traits where other biologics have distinct benefits.

Bottom line: If your patient needs IL-5 pathway blockade, depemokimab offers parity on efficacy and safety with a lot less frequent dosing.

References:

Bourdin A et al. Depemokimab reduces asthma exacerbations similarly to other biologics. Ann Allergy Asthma Immunol 2026;137:329-339.

https://www.annallergy.org/article/S1081-1206(26)00218-8/fulltext