Clinical Outcomes and Health-Care Resource Use Associated With Reslizumab Treatment in Adults With Severe Eosinophilic Asthma in Real-World Practice

Wechsler, Michael E.; Peters, Stephen P.; Hill, Tanisha; Ariely, Rinat; DePietro, Michael; Driessen, Maurice; Terasawa, Emi; Thomason, Darren; Panettieri, Reynold A.

doi:10.1016/j.chest.2020.11.060

Cited by 25 publications

(28 citation statements)

References 15 publications

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“…Interestingly, data on mepolizumab reported from very large and long-term realworld studies [42,50,56] were generally consistent with those obtained for omalizumab with respect to both the percentage of patients that discontinued OCS and the reduction in the daily dose of OCS in those patients that still required maintenance OCS to control the disease. The only very large study [85] on reslizumab also confirmed that mAb therapy is able to halve the percentage of patients requiring maintenance OCS, although reslizumab reduced the daily dose of OCS slightly less than omalizumab and mepolizumab among the patients that continued to need OCS. However, we have to highlight that the daily dose of OCS at baseline in the very large studies on omalizumab [74,78,82] and mepolizumab studies [42,50,56] were generally lower than that of the very large study on reslizumab [85].…”

Section: Discussionmentioning

confidence: 93%

“…The only very large study [85] on reslizumab also confirmed that mAb therapy is able to halve the percentage of patients requiring maintenance OCS, although reslizumab reduced the daily dose of OCS slightly less than omalizumab and mepolizumab among the patients that continued to need OCS. However, we have to highlight that the daily dose of OCS at baseline in the very large studies on omalizumab [74,78,82] and mepolizumab studies [42,50,56] were generally lower than that of the very large study on reslizumab [85]. Only one large real-world study [34] has been carried out on benralizumab, which permitted OCS consumption to be abolished in all the observed patients.…”

Section: Discussionmentioning

confidence: 93%

“…Of the 1757 potentially relevant records identified in the initial search, 59 real-world studies were deemed eligible for a qualitative analysis. Six studies were carried out on benralizumab [34][35][36][37][38][39], 1 on dupilumab [40], 18 on mepolizumab [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], 27 on omalizumab [18,, and 3 on reslizumab [85][86][87]. Four studies investigated different mAbs in the same report [88][89][90][91].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Only three studies [85][86][87] investigated the impact on OCS use of reslizumab in realworld settings.…”

Section: Reslizumabmentioning

confidence: 99%

“…A very large study [85] showed that 35.1%, 45.9%, and 53.2% of patients with severe eosinophilic asthma discontinued OCS after 4, 7, and 10 months of treatment with reslizumab, respectively. Among the patients that continued to use OCS, the daily dose decreased from 20.6 mg/day to 15.5 mg/day after reslizumab initiation.…”

Section: Reslizumabmentioning

confidence: 99%

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Oral Corticosteroids Dependence and Biologic Drugs in Severe Asthma: Myths or Facts? A Systematic Review of Real-World Evidence

Calzetta

Aiello

Frizzelli

et al. 2021

IJMS

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Airway inflammation represents an important characteristic in asthma, modulating airflow limitation and symptom control, and triggering the risk of asthma exacerbation. Thus, although corticosteroids represent the cornerstone for the treatment of asthma, severe patients may be dependent on oral corticosteroids (OCSs). Fortunately, the current humanised monoclonal antibodies (mAbs) benralizumab, dupilumab, mepolizumab, omalizumab, and reslizumab have been proven to induce an OCS-sparing effect in randomized controlled trials (RCTs), thus overcoming the problem of OCS dependence in severe asthma. Nevertheless, a large discrepancy has been recognized between selected patients enrolled in RCTs and non-selected asthmatic populations in real-world settings. It is not possible to exclude that the OCS-sparing effect of mAbs resulting from the RCTs could be different than the real effect resulting in clinical practice. Therefore, we performed a systematic review and correlation analysis to assess whether mAbs are effective in eliciting an OCS-sparing effect and overcoming the OCS dependence in severe asthmatic patients in real-world settings. Overall, real-world studies support the evidence that OCS dependence is a real condition that, however, can be found only in a small number of really severe asthmatic patients. In most patients, the dependence on OCS can be related to modifying factors that, when adequately modulated, may lead to a significant reduction or suspension of OCS maintenance. Conversely, in severe asthmatics in whom OCS resistance is proved by a high daily dose intake, mAbs allow reversion of the OCS dependence, leading to the suspension of OCS therapy in most patients or >50% reduction in the daily OCS dose.

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