Anti–IL-5 biologics, such as mepolizumab and benralizumab, have demonstrated significant efficacy in reducing moderate and severe exacerbations in patients with both asthma and chronic obstructive pulmonary disease (COPD), according to new real-world data presented at the 2025 American Thoracic Society (ATS) International Conference. These findings reinforce the therapeutic potential of eosinophil-targeting agents in patients with overlapping respiratory disease, says GlobalData.
GlobalData’s latest analysis highlights the results of a retrospective study from Ghent University Hospital based on Belgian national claims data, evaluating 807 adults who initiated anti–IL-5 therapy between 2017 and 2020. Of these, 191 patients were diagnosed with both asthma and COPD. Across the cohort, severe exacerbations declined by 56 per cent, from 40 to 17 events per 100 patient-years, with the most pronounced benefit observed in the asthma–COPD overlap subgroup (119 to 53 events; 55 per cent reduction; NNT=2).
Asiyah Nawab, Healthcare Analyst, GlobalData, comments, “These real-world findings add to the growing evidence base supporting IL-5 inhibition in eosinophilic airway disease. The observed reduction in hospitalisations—especially among patients with coexisting asthma and COPD—underscores the value of mechanism-driven biologics in high-cost, high-need populations.”
Moderate exacerbations also declined across most subgroups. In patients with asthma–COPD overlap, antibiotic-only events fell by 20 per cent, while combined oral corticosteroid and antibiotic events dropped by 21 per cent. Although corticosteroid-only exacerbations were less responsive, especially among current smokers, reductions in hospital-based care remained significant (64 per cent reduction; NNT=1), highlighting biologics’ capacity to alleviate healthcare system burden.
These results emphasise the clinical and economic relevance of eosinophilic inflammation as a precision medicine target in obstructive airway diseases. The consistent benefit across patients with diverse comorbidities and smoking histories supports the use of anti–IL-5 therapy beyond classical severe asthma populations and positions these agents as integral to a phenotype-guided treatment strategy.
Nawab continues, “In a respiratory market increasingly defined by biomarker segmentation, the ability of IL-5 biologics to prevent hospitalisations is a compelling value proposition—particularly in cost-conscious health systems. These data could support health technology assessments and future label expansions into asthma–COPD overlap populations.”
Commercially, this evidence strengthens the positioning of mepolizumab and benralizumab in the evolving biologics landscape. While newer agents such as anti–IL-4R therapies may offer broader coverage across type 2 inflammatory profiles, IL-5 inhibitors remain the preferred option in patients with persistent eosinophilia and frequent exacerbations.
Nawab concludes, “Real-world outcomes in overlapping disease populations are critical for payers and prescribers alike. With hospitalisation prevention emerging as a key differentiator, IL-5 biologics are well-positioned to expand their reach, provided they are backed by robust patient selection tools and economically justified value frameworks.”