Omalizumab or dupilumab suggested for adults with moderate-to-severe allergic asthma, history of exacerbations requiring oral corticosteroids
THURSDAY, Jan. 22, 2026 (HealthDay News) — In a clinical practice guideline issued by the American College of Chest Physicians and published online in CHEST, recommendations are presented to optimize the use of biologic agents for severe asthma in adults.
Amber J. Oberle, M.D., from Duke University in Durham, North Carolina, and colleagues conducted a systematic review and meta-analysis and developed recommendations relating to the choice of biologic agent in severe asthma for adult patients.
The authors developed seven recommendations. Among these recommendations, they suggest using either omalizumab or dupilumab in adults with moderate-to-severe allergic asthma and a history of one or more exacerbations per year requiring oral corticosteroids; dupilumab is suggested over omalizumab for those with frequent exacerbations or any severe exacerbation requiring hospitalization and for patients with a greater impairment in lung function, while omalizumab is suggested over dupilumab for patients with more severe impairments in quality of life. Either anti-IL5/5Rα therapy or dupilumab is suggested for adults with severe asthma who are steroid-dependent. Dupilumab is suggested over tezepelumab for adults with severe asthma who are steroid dependent. Either anti-IL5/5Rα therapy or dupilumab is suggested for adults with moderate-to-severe asthma who have not demonstrated a clinical response to omalizumab after four to six months; dupilumab or tezepelumab are suggested for adults with severe asthma who have not demonstrated a clinical response to anti-IL5/5Rα therapy after four to six months.
“In addition to following this guideline, decisions as to how to individualize biological therapy should occur under a shared decision-making process that carefully considers underlying asthma comorbidities, T2 biomarkers, injection frequency, mode of administration, and access to resources,” Oberle said in a statement.
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