Efficacy and Safety of Mepolizumab in a Real-World Cohort of Patients with Severe Eosinophilic Asthma

Pertzov, Barak; Unterman, Avraham; Shtraichman, Osnat; Shitenberg, Dorit; Rosengarten, Dror; Kramer, Mordechai

doi:10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3037

Cited by 17 publications

(38 citation statements)

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“…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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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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“…In randomized clinical trials (RCT), mepolizumab has been demonstrated to produce a significant reduction in exacerbations and steroid intake and to improve asthma control in patients with a peripheral eosinophil count >300 cell/mm 3 [9, 10]. These results have also been reported in real-world studies, confirming the cost-effectiveness and good safety profile of the drug [11, 12].…”

Section: Introductionmentioning

confidence: 79%

A Comprehensive Evaluation of Mepolizumab Effectiveness in a Real-Life Setting

Cameli

Bergantini

d’Alessandro

et al. 2020

Int Arch Allergy Immunol

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Introduction: Interleukin-5 (IL-5) is the principal cytokine regulating eosinophil growth, differentiation, activation, and expression. It is a specific target of mepolizumab, an anti-IL-5 monoclonal antibody used in the treatment of severe eosinophilic asthma. This new drug can improve symptoms, reduce asthma exacerbations and steroid use. Few data are available on its efficacy for nasal symptoms. Objective: To describe the all-round clinical impact of mepolizumab in a real-life setting, evaluating the efficacy and safety of the drug in severe eosinophilic asthma patients. Population and Methods: We retrospectively collected the clinical and functional data on 27 patients (16 males) affected with severe eosinophilic asthma, diagnosed at the Siena Regional Referral Centre and monitored for 6 months. Clinical, immunological, and functional data at baseline and follow-up were entered in a database together with comorbidities, number of exacerbations, steroid treatment, multiple-flow exhaled nitric oxide, and validated questionnaires. Results: A significant reduction in asthma exacerbations was observed in all patients after 6 months of the biological therapy (p = 0.0009), and 4/6 patients discontinued chronic oral steroids. A significant improvement in ACT, FEV1, SNOT22, and alveolar nitric oxide was observed after 1 month of mepolizumab (p = 0.003, p = 0.007, p = 0.047, and p = 0.019, respectively) and maintained after 6 months of treatment. After 6 months, FeNO 50 was reduced as well (p = 0.030). Mepolizumab was very well tolerated, and no major side effects were observed. Conclusions: Our study suggests that mepolizumab is effective in improving control of asthma, lung function parameters, exhaled biomarkers, and nasal symptoms in patients with severe eosinophilic asthma.

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“…We examined and evaluated the following parameters at baseline and at the final follow-up after 4 months: peripheral blood eosinophil and basophil counts, serum IgE, fractional exhaled nitric oxide (FeNO), the Asthma Control Test (ACT) score, pulmonary function test results [the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), FEV 1 /FVC, %FEV 1 and % peak expiratory flow (%PEF)], and daily OCS maintenance doses as prednisone equivalents (mg). A change of 200 ml or greater was adopted as a significant change in the FEV 1 [12,[14][15][16]. The FeNO level was measured using a NIOX VERO™ device (Aerocrine AB, Stockholm, Sweden) with a 50 ml/s flow rate according to the American Thoracic Society/European Respiratory Society recommendations [17].…”

Section: Data Collection and Evaluationmentioning

confidence: 99%

Efficacy of benralizumab for patients with severe eosinophilic asthma: a retrospective, real-life study

et al. 2020

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Background: Benralizumab, an anti-interleukin-5 (IL-5) receptor α monoclonal antibody, significantly reduces the number of annual exacerbations and oral corticosteroid (OCS) maintenance doses for patients with severe eosinophilic asthma (SEA). However, few studies on the efficacy of this biologic in real life are available. The aim was to elucidate the efficacy of benralizumab by evaluating changes in clinical parameters after benralizumab treatment in patients with SEA. Methods: From July 2018 to December 2019, 24 Japanese patients with SEA received benralizumab at Jikei University Hospital. We retrospectively evaluated the patients' characteristics, parameters, numbers of exacerbations and maintenance OCS doses. Results: Among the 24 patients, eleven patients had received mepolizumab treatment and were directly switched to benralizumab. The peripheral blood eosinophil and basophil counts significantly decreased after benralizumab treatment regardless of previous mepolizumab treatment. Pulmonary function, Asthma Control Test scores, the numbers of annual exacerbations and maintenance OCS doses in patients without previous mepolizumab treatment tended to improve without significant differences. Fourteen patients (58%) were responders according to the Global Evaluation of Treatment Effectiveness (GETE) score. The proportion of GETE responders among patients with aspirin-exacerbated respiratory disease (AERD) tended to be lower than that among patients without AERD (p = 0.085). After benralizumab treatment, the change in the forced expiratory volume in 1 s from baseline was 200 ml or greater in eight patients (33%), including three patients who were switched from mepolizumab. Conclusion: Benralizumab treatment improved and controlled asthma symptoms based on the GETE score.

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Efficacy and Safety of Mepolizumab in a Real-World Cohort of Patients with Severe Eosinophilic Asthma

Cited by 17 publications

References 0 publications

Clinical Experience in the Treatment of Severe Eosinophilic Asthma With Mepolizumab

Clinical Experience in the Treatment of Severe Eosinophilic Asthma With Mepolizumab

A Comprehensive Evaluation of Mepolizumab Effectiveness in a Real-Life Setting

Efficacy of benralizumab for patients with severe eosinophilic asthma: a retrospective, real-life study

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