OBJECTIVES : Asthma is a heterogeneous chronic disease. One of its endotypes is eosinophilic asthma. Peripheral blood eosinophilia is often associated with more severe asthma course. Anti-IL5 monoclonal antibodies (mAbs) are able to reduce blood and tissue eosinophilia in asthma patients. The first anti-IL5 mAb in Russia was reslizumab. The aim is to evaluate clinical and economic feasibility of using reslizumab vs. omalizumab in patients with severe atopic asthma and blood eosinophilia.

METHODS : Omalizumab was chosen as a comparator as it was the only targeted agent for severe asthma treatment approved in Russia in 2019. The patient population included asthma patients with both high IgE levels and blood eosinophilia, i.e. those who were suitable for treatment with either omalizumab or reslizumab. The criterion of efficacy was reduction of exacerbations requiring administration of systemic corticosteroids and QALY gain. An indirect comparison of efficacy was performed as no direct comparison was available. It was shown that treatment with reslizumab led to significantly greater reduction of exacerbations than treatment with omalizumab. The utility of two treatment strategies was compared using Markov models, taking into account the frequency of exacerbations, their severity, and associated QALY loss. Modelling horizon was 12 months.

RESULTS : The therapy with reslizumab appeared to be 37.2% less expensive than with omalizumab. The calculated CER and CUR were in favor of reslizumab. Budget impact analysis demonstrated a significant effect of administration of reslizumab on budget savings. For estimated 4,250 patients with severe atopic asthma with eosinophilia in Russia, the use of reslizumab would be able to save budget funds in the amount up to 4,896,310,139 rubles (appr. 75,327,848 USD) a year.

CONCLUSIONS : Reslizumab may be an effective and cost-saving alternative to omalizumab in patients with atopic asthma and eosinophilia.