Drug design, development and therapy
Comparative Real-World Effectiveness of Dupilumab, Mepolizumab, and Benralizumab in Patients with Chronic Obstructive Pulmonary Disease: A Propensity Score-Matched Cohort Study
By Liao KM, Huang SC, Wu JY and 4 others.
Abstract
Background
Dupilumab, mepolizumab, and benralizumab have each demonstrated efficacy in placebo-controlled trials for chronic obstructive pulmonary disease (COPD) with type 2 inflammation. However, no head-to-head trials or real-world comparative effectiveness studies have been reported. We aimed to compare the effectiveness of dupilumab, mepolizumab, and benralizumab in patients with COPD using propensity score-matched cohort analyses.
Design
Retrospective cohort study using the TriNetX US Collaborative Network.
Methods
Adults with COPD initiating dupilumab, mepolizumab, or benralizumab between 2022 and 2025 were identified. Biologic-naive new users were included in two pairwise comparisons: dupilumab versus mepolizumab and dupilumab versus benralizumab. Propensity score matching (1:1) balanced baseline characteristics. The primary outcome was COPD exacerbation; secondary outcomes included acute respiratory failure, pneumonia, and bronchitis over 365 days. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.