Efficacy of mepolizumab in usual clinical practice and characteristics of responders. (October 2021)

• Record Type: Journal Article
• Authors: Rodríguez-García, Carlota; Blanco-Aparicio, Marina; Nieto-Fontarigo, Juan José; Blanco-Cid, Nagore; Gonzalez-Fernandez, Coral; Mosteiro-Añon, Mar; Calvo-Alvarez, Uxío; Perez-De-Llano, Luis; Corbacho-Abelaira, María Dolores; Lourido-Cebreiro, Tamara; Dominguez-Juncal, Luis Miguel; Crespo-Diz, Carlos; Dacal-Quintas, Raquel; Pallares-Sanmartin, Abel; Dacal-Rivas, David; Gonzalez-Barcala, Francisco Javier
• Is Part Of: Respiratory medicine. Volume 187(2021)
• Publication Date: 2021-10
• Subjects: Asthma -- Eosinophils -- Mepolizumab -- Monoclonal antibodies -- Interleukin-5 -- Precision medicine; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106595
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Severe eosinophilic asthma is a high-burden disease. Mepolizumab has been effective in several randomized clinical trials. However, such success might not be applicable to patients treated in usual clinical practice. The objectives of this article are to evaluate the efficacy of mepolizumab in severe uncontrolled eosinophilic asthma under usual clinical practice, and to determine characteristics associated with the response to this treatment. Methods: We have conducted a retrospective, multicentre study, including all adult patients with severe uncontrolled eosinophilic asthma in Galicia, Spain, on whom mepolizumab treatment was started before June 2020, at least 6 months before the time of inclusion, and had received at least one dose of the drug. Patient characteristics, clinical data, respiratory function and comorbidities were collected at baseline and at the 6-month-follow-up. Responders and super-responders were defined according to clinical response and requirement of systemic corticosteroids. Results: 122 patients (mean age 58 years old) were included. In the follow-up treatment 6 months later, 75.4% of the patients were well-controlled, displaying a significant reduction in blood eosinophil counts (p < 0.001), hospital admissions and disease exacerbations (p < 0.001), and had their systemic glucocorticosteroid dose significantly reduced (p < 0.001). The inhaled corticosteroid dose was also lowered (p < 0.01) after 6 months of treatment. Around two-thirds had a clinically significant increase in FEV1, 95% of the patients were considered responders and 43% super-responders. Conclusion: In routine clinical practice, mepolizumab is effective in patients with severe eosinophilic asthma and it has a good safety profile. Highlights: Mepolizumab is efficient in severe eosinophilic asthma in usual clinical practice. Asthma control and lung function improved after treatment with mepolizumab. Mepolizumab reduced hospital admissions, exacerbations and need of systemic steroids.