Twice-yearly depemokimab held exacerbation rates down over two years

Design

Open-label extension with integrated post hoc 2-year analysis of two phase 3a RCTs

Population

629 patients ≥12 with eosinophilic type 2 asthma and ≥2 exacerbations a year

Primary outcome

Safety and immunogenicity; exacerbation rate secondary

Effect

Annualised exacerbation rate 0.51 (year 1) and 0.56 (year 2); serious adverse events 9%

Depemokimab is a long-acting anti-IL-5 antibody given every 26 weeks. The SWIFT-1 and SWIFT-2 phase 3a trials enrolled patients aged 12 or over with eosinophilic, type 2 asthma and at least two exacerbations a year despite medium- or high-dose inhaled steroids. This analysis covers the 52-week open-label AGILE extension (629 patients) and an integrated post hoc analysis of the full two years.

In patients on depemokimab throughout, the annualised exacerbation rate was 0.51 in the first year and 0.56 in the second. Quality of life, asthma control and FEV₁ gains were maintained, and patients switched from placebo improved after starting the drug. Adverse events were similar between groups (about 70%), serious adverse events occurred in 9%, and none were judged treatment-related or fatal. The study was industry funded.

Two injections a year could ease adherence and clinic burden for patients with severe eosinophilic asthma. Its licensing and availability in India are not established here, and the extension was open-label without a control group.

• Consider anti-IL-5 biologics for eosinophilic asthma with two or more exacerbations a year despite inhaled steroids.
• Confirm inhaler technique and adherence before escalating to a biologic.
• Check blood eosinophils, which define eligibility for anti-IL-5 therapy.
• Check local licensing and cost for depemokimab before discussing it with patients.

Why it matters

Fewer injections could make biologic therapy easier to sustain for patients who struggle to attend.

Don't overread it

The second year was an open-label extension without a comparator, so it shows durability, not superiority.

The statistics, in plain English

An annualised exacerbation rate of 0.56 means about one exacerbation every two years per patient on average. Without a control arm in the extension, the figure cannot be compared directly with placebo or other biologics.

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