• Media type: E-Article
  • Title: Mepolizumab effectiveness and identification of super-responders in severe asthma
  • Contributor: Harvey, Erin S.; Langton, David; Katelaris, Constance; Stevens, Sean; Farah, Claude S.; Gillman, Andrew; Harrington, John; Hew, Mark; Kritikos, Vicky; Radhakrishna, Naghmeh; Bardin, Philip; Peters, Matthew; Reynolds, Paul N.; Upham, John W.; Baraket, Melissa; Bowler, Simon; Bowden, Jeffrey; Chien, Jimmy; Chung, Li Ping; Grainge, Christopher; Jenkins, Christine; Katsoulotos, Gregory P.; Lee, Joy; McDonald, Vanessa M.; [...]
  • imprint: European Respiratory Society (ERS), 2020
  • Published in: European Respiratory Journal
  • Language: English
  • DOI: 10.1183/13993003.02420-2019
  • ISSN: 0903-1936; 1399-3003
  • Origination:
  • Footnote:
  • Description: <jats:p>Severe asthma is a high-burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population.</jats:p><jats:p>The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia.</jats:p><jats:p>Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58% female) commenced mepolizumab. They had poor symptom control (median Asthma Control Questionnaire (ACQ)-5 score of 3.4), frequent exacerbations (median three courses of oral corticosteroids (OCS) in the previous 12 months), and 47% required daily OCS. Median baseline peripheral blood eosinophil level was 590 cells·µL<jats:sup>−1</jats:sup>. Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%.</jats:p><jats:p>Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95% CI 0.29–0.41); p&lt;0.001) and hospitalisations (rate ratio 0.46 (95% CI 0.33–0.63); p&lt;0.001). Treatment improved symptom control (median ACQ-5 reduced by 2.0 at 6 months), quality of life and lung function. Higher blood eosinophil levels (p=0.003) and later age of asthma onset (p=0.028) predicted a better ACQ-5 response to mepolizumab, whilst being male (p=0.031) or having body mass index ≥30 (p=0.043) predicted a lesser response. Super-responders (upper 25% of ACQ-5 responders, n=61, 24%) had a higher T2 disease burden and fewer comorbidities at baseline.</jats:p><jats:p>Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.</jats:p>
  • Access State: Open Access