Depemokimab: toward biannual biologic therapy for severe eosinophilic asthma

Severe eosinophilic asthma remains a major therapeutic challenge despite advances in biologic therapies targeting type 2 inflammation. Depemokimab (Exdensur®), a novel ultra-long-acting anti-interleukin-5 (IL-5) monoclonal antibody, introduces a new treatment paradigm through sustained eosinophil suppression and twice-yearly administration. Engineered with enhanced IL-5 binding affinity and fragment crystallizable (Fc) modifications that prolong systemic persistence, depemokimab achieves durable pharmacodynamic activity and extended dosing intervals. Phase III SWIFT-1 and SWIFT-2 trials demonstrated significant reductions in annualized asthma exacerbations, with efficacy comparable to established anti-IL-5 agents and a favorable safety profile. However, benefits in lung function, symptom control, and quality of life have been less consistent, underscoring the complex relationship between eosinophilic inflammation and broader disease manifestations. The principal advantage of depemokimab lies in its potential to reduce treatment burden, improve adherence, and decrease healthcare utilization. As severe asthma management evolves, depemokimab represents a promising patient-centered option, although optimal patient selection and long-term outcomes require further investigation.