TY - JOUR
T1 - Mepolizumab effectiveness and identification of super-responders in severe asthma
AU - Harvey, Erin S.
AU - Langton, David
AU - Katelaris, Constance
AU - Stevens, Sean
AU - Farah, Claude S.
AU - Gillman, Andrew
AU - Harrington, John
AU - Hew, Mark
AU - Kritikos, Vicky
AU - Radhakrishna, Naghmeh
AU - Bardin, Philip
AU - Peters, Matthew
AU - Reynolds, Paul N.
AU - Upham, John W.
AU - Baraket, Melissa
AU - Bowler, Simon
AU - Bowden, Jeffrey
AU - Chien, Jimmy
AU - Chung, Li Ping
AU - Grainge, Christopher
AU - Jenkins, Christine
AU - Katsoulotos, Gregory P.
AU - Lee, Joy
AU - McDonald, Vanessa M.
AU - Reddel, Helen K.
AU - Rimmer, Janet
AU - Wark, Peter A. B.
AU - Gibson, Peter G.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - 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.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.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-1 Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%.Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95% CI 0.29-0.41); p<0.001) and hospitalisations (rate ratio 0.46 (95% CI 0.33-0.63); p<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.Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.
AB - 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.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.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-1 Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%.Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95% CI 0.29-0.41); p<0.001) and hospitalisations (rate ratio 0.46 (95% CI 0.33-0.63); p<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.Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.
UR - http://www.scopus.com/inward/record.url?scp=85085263602&partnerID=8YFLogxK
U2 - 10.1183/13993003.02420-2019
DO - 10.1183/13993003.02420-2019
M3 - Article
C2 - 32139455
AN - SCOPUS:85085263602
SN - 0903-1936
VL - 55
SP - 1
EP - 13
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 5
M1 - 1902420
ER -