Mepolizumab beneficial in severe eosinophilic asthma
Use of mepolizumab in the treatment of severe eosinophilic asthma reduces exacerbation frequency and oral corticosteroid requirement, according to a study. Factors associated with better outcomes include nasal polyposis, lower body mass index (BMI) and lower maintenance prednisolone requirement.
Researchers examined the medical records of 99 patients who received ≥16 weeks of treatment with mepolizumab (100 mg administered subcutaneously). Clinical data were recorded every 4 weeks, with response assessed at weeks 16, 24 and 52. Response was defined as ≥50-percent decrease in exacerbation episodes, or a ≥50-percent drop in prednisolone dose for patients requiring maintenance oral corticosteroids (mOCS). Super-responders were defined as exacerbation-free and off mOCS at month 12.
Mean asthma exacerbation frequency decreased by 54 percent, from 4.04 at baseline to 1.86 at year 1 (p<0.001). Meanwhile, 68 patients were on mOCS at the time of mepolizumab initiation. The daily median dose dropped from 10 mg at baseline to 0 mg at year 1, and 57 percent of the patients on mOCS were able to discontinue treatment.
Overall, 72.7 percent of patients responded to mepolizumab; 28.3 percent were identified as super-responders. Baseline characteristics associated with responder and super-responder status were as follows: the presence of nasal polyposis (p=0.012), lower baseline 6-item Asthma Control Questionnaire score (p=0.006), a lower BMI (p=0.014), and a significantly lower prednisolone dose at baseline in patients on mOCS (p=0.005).
The 1-year responder status was correctly identified in 80.8 percent of the patients at week 16, and this number increased to 92.9 percent at week 24.
Mepolizumab was the first licensed anti-interleukin-5 mAb for severe eosinophilic asthma.