Effectiveness and safety of mepolizumab in severe refractory eosinophilic asthma: results in clinical practice

Pérez, O Montero; Contreras-Rey, María Beatriz; Sánchez-Gómez, E.

doi:10.7573/dic.212584

Cited by 27 publications

(34 citation statements)

References 10 publications

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“…15,16 Recently, several smaller studies based on real-world data have also shown that mepolizumab is associated with a reduction in exacerbations. 17,18 Taken together with our findings, this highlights the beneficial effect of mepolizumab on exacerbation frequency irrespective of seasonality.…”

Section: Discussionsupporting

confidence: 85%

“…Although not a formal objective of this study, we observed reductions in chronic OCS use with mepolizumab treatment, a finding that is consistent with results from the previous clinical trials of mepolizumab, 12,19,20 as well as other recent analyses of real-world data on mepolizumab treatment. 17,18 A recent longitudinal database study showed that increasing the number of OCS prescriptions is associated with increased odds of experiencing an adverse event. Thus, a reduction in the use of OCS may improve outcomes in patients with asthma.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Real-World Effectiveness of Mepolizumab in Patients with Severe Asthma: An Examination of Exacerbations and Costs</p>

Llanos

Ortega

Bogart

et al. 2020

JAA

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Rationale: Results from clinical trials in patients with severe eosinophilic asthma have demonstrated that mepolizumab is well tolerated and is associated with improved asthma control as evidenced by reductions in both exacerbations and maintenance oral corticosteroid use, and improvements in lung function, asthma control, and quality of life. However, real-world data are lacking on the impact of mepolizumab treatment. Objective: To assess the effect of mepolizumab treatment on the rate of asthma exacerbations and asthma exacerbation-related costs in a real-world setting.Methods: This retrospective cohort study (GSK ID: 209017; HO-18-19168) analyzed data from patients with severe asthma ≥12 years of age at mepolizumab treatment initiation (index date) with ≥12 months pre-(baseline) and post-index (follow-up) data from a commercial claims database (patients were identified from November 1, 2015 to March 31, 2017). Asthma exacerbations (primary objective) and asthma exacerbationrelated costs (secondary objective) in the baseline and follow-up periods were compared. Other analyses included the number of mepolizumab administrations and the use of concomitant asthma medications. Results: Data were analyzed from 346 patients. Mepolizumab significantly reduced the proportion of patients with any exacerbation and exacerbations requiring hospitalization, compared with baseline. Significant reductions in the rate of all exacerbations of 38.4% (from 2.68 to 1.65 events/patient/year; P<0.001) and of exacerbations requiring hospitalization of 72.7% (from 0.11 to 0.03 events/patient/year; P=0.004) were observed, compared with baseline. Mean total asthma exacerbation-related costs (excluding mepolizumab acquisition and administrative costs) per person were significantly lower during follow-up compared with baseline (P<0.05) and the use of asthma medications, including oral and inhaled corticosteroids, was also lower. Conclusion: This study confirms the clinical benefit observed in previous mepolizumab clinical trials and demonstrates that mepolizumab is effective in a real-world setting. Plain-Language SummaryWhy was the study done? Mepolizumab is a biologic therapy given as an add-on treatment to patients with severe asthma whose symptoms are not controlled with controller therapy. Mepolizumab has been shown to reduce the rate of asthma exacerbations and use of oral corticosteroids in clinical trials, but there is currently a lack of data on the impact of mepolizumab treatment initiation in a real-world setting.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

<p>Real-World Effectiveness of Mepolizumab in Patients with Severe Asthma: An Examination of Exacerbations and Costs</p>

Llanos

Ortega

Bogart

et al. 2020

JAA

View full text Add to dashboard Cite

show abstract

“…The results show a clear improvement for the patients, which is reflected in a reduction of the number of exacerbations, improved clinical control, and a reduction in the use of OCS. The data are very similar to those in the literature, both in the controlled clinical trials (5-9) and in the real-life studies carried out with the drug (11,(15)(16)(17)(18). In this way, the type of patients included in our series are very similar to those already published, both in existence of associated comorbidities and in the presence of secondary effects attributed to the administration of the drug.…”

Section: Discussionsupporting

confidence: 87%

Clinical Experience in the Treatment of Severe Eosinophilic Asthma With Mepolizumab

Rodríguez

Valverde

Álvarez

et al. 2020

Preprint

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Introduction: Severe eosinophilic asthma is an incapacitating disease requiring the patient to take many drugs, amongst which are oral corticoids (OCS), for its control. Mepolizumab is a monoclonal antibody capable of blocking the binding of Interleukin 5 (IL-5) to the eosinophils, and, in this way reducing the exacerbations, symptoms and need for OCS. Our objective was to evaluate the experience with this drug on patients being treated for severe asthma in real-life conditions. Methods: Retrospective, multicentric study carried out in eight hospitals in the Principality of Asturias, in which the demographic, clinical, analytical, lung function and ACT (Asthma Control Questionnaire) data of the patients with severe eosinophilic asthma being treated with Mepolizumab for three years were collected. Results: Sixty-nine patients (72% women) were included, with a mean age of 56±13 years. The eosinophil blood count before treatment was 856 cels/mm3 (SD 754), decreasing after 6 months to 101 cels/mm3 (SD 98). Annual exacerbations decreased from 4.7 (SD 3.7) to 1.3 (SD 2.5) (p=0.001), while the FEV1% increased from 68% (SD 20) to 76% (SD 21) (<0.001). At the onset 25 patients (36%) were using OCS ( 18 mg/day of prednisone) and after treatment this decreased to 13 (19%) ( 9mg/day of prednisone) ( p=0.000), with complete withdrawal in 12 (48%). The response to Mepolizumab was positive in 56 patients (81%), and no adverse effects were observed. Conclusions: Mepolizumab has demonstrated to be efficacious and safe in real life in the treatment of patients with badly controlled eosinophilic asthma.

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“…Eosinophilia during asthma development is associated with pro-inflammatory cytokines such as IL-4, IL-5 and IL-13 [23,24]. These cytokines are involved in driving the maturation, activation, and accumulation of eosinophils within damaged lung lesions, leading to IgE production, airway inflammation, mucus overproduction, and AHR [25,26]. Therefore, the modulation of pro-inflammatory cytokines is regarded as an important strategy for controlling asthma.…”

Section: Discussionmentioning

confidence: 99%

Scrophularia koraiensis Nakai Attenuates Allergic Airway Inflammation via Suppression of NF-κB and Enhancement of Nrf2/HO-1 Signaling

et al. 2020

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Scrophularia koraiensis Nakai (Scrophulariaceae) is a medicinal herb that grows in Korea and which has been widely used to treat fever, edema, neuritis and laryngitis. Hence, we evaluated the anti-inflammatory and antioxidant effects of the ethanol extract (SKE) of S. koraiensis Nakai in an ovalbumin (OVA)-induced mouse model. We injected 20 μg of OVA with 2 mg of aluminum on day 0 and day 14 to induce allergic airway inflammation in six-week-old BALB/c mice, and mice were challenged with 1% OVA by nebulization for 1 h on days 21, 22, and 23. SKE was orally administered at 20 mg/kg and 40 mg/kg from day 18 to 23, and its effects were compared with those of montelukast treatment. SKE significantly reduced proinflammatory cytokines, inflammatory cell counts, immunoglobulin-E, and airway hyperresponsiveness during the OVA-induced allergic airway inflammation model; it also reduced airway inflammation and mucus production. In addition, SKE reduced the OVA-induced nuclear factor kappa B (NF-κB) phosphorylation in lung tissues while enhancing nuclear factor erythroid-derived 2-related factor (Nrf-2) and heme oxygenase-1 (HO-1) expression. In conclusion, SKE showed the protective effects on OVA-induced allergic airway inflammation via the suppression of NF-κB phosphorylation and the enhancement of the Nrf2/HO-1 signaling pathway. These results indicate that SKE is a potential therapeutic agent for allergic airway inflammation.

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Effectiveness and safety of mepolizumab in severe refractory eosinophilic asthma: results in clinical practice

Cited by 27 publications

References 10 publications

<p>Real-World Effectiveness of Mepolizumab in Patients with Severe Asthma: An Examination of Exacerbations and Costs</p>

<p>Real-World Effectiveness of Mepolizumab in Patients with Severe Asthma: An Examination of Exacerbations and Costs</p>

Clinical Experience in the Treatment of Severe Eosinophilic Asthma With Mepolizumab

Scrophularia koraiensis Nakai Attenuates Allergic Airway Inflammation via Suppression of NF-κB and Enhancement of Nrf2/HO-1 Signaling

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