Positioning of Depemokimab in Uncontrolled Severe Asthma

Asthma is a chronic inflammatory disease of the airways affecting more than 300 million people worldwide. It is estimated that between 3% and 10% have severe asthma. Depemokimab is the first ultra-long-acting anti-IL-5 monoclonal antibody developed for type 2 respiratory disease, enabling administration every 26 weeks. It produces rapid and sustained reductions in blood eosinophil counts. This twice-yearly regimen markedly reduces injection frequency and may lessen treatment burden. In the replicate phase 3 SWIFT-1 and SWIFT-2 trials, depemokimab reduced the pooled annualized rate of clinically significant exacerbations by 54% and exacerbations requiring hospitalization or emergency department care by 72% compared with placebo in patients aged 12 years or older with severe eosinophilic asthma. In chronic rhinosinusitis with nasal polyps (CRSwNP), depemokimab was evaluated in the replicate phase 3 ANCHOR-1 and ANCHOR-2 trials. Both coprimary endpoints were met, and these studies provide evidence that twice-yearly depemokimab reduces the endoscopic nasal polyp score and improves nasal obstruction over 52 weeks in inadequately controlled CRSwNP. Depemokimab is approved for both severe asthma with type 2 inflammation and severe CRSwNP, making it a therapeutic option when both conditions coexist. Based on currently available evidence, depemokimab represents an additional option for patients with severe eosinophilic asthma in whom prevention of exacerbation is a major therapeutic goal. The twice-yearly dosing schedule may also be relevant when reducing treatment burden is a patient priority, although the effect of this reduction on adherence and persistence remains to be proved.