<p>Self-Administered Mepolizumab in the Management of Severe Asthma: Usability and Patient Acceptance</p>

Abstract

The increasing use of advanced biologic therapies for patients with severe asthma is transforming the standard of care, clinic workflow, and the clinic business model. Expanded patient access to at-home injection treatment possibilities with some biologics has the potential to improve patient adherence and outcomes. Simultaneously, transition to the home setting can address the escalating costs that limit access for certain patients and healthcare facilities. Such moves come with recognized risks. Garnering input from physicians and other healthcare specialists as well as scrutinizing best practice position statements are vital to implementing truly patient-safe and cost-effective strategies in medicine. Mepolizumab is the first anti-IL-5 inhibitor to receive FDA approval in late 2015. We focus on this injectable medication and discuss the specific indications and contraindications for transitioning patients to at-home injection with mepolizumab. In doing so, we review our recent real-world experiences in the University of California, Davis and Loma Linda University severe asthma clinics, which can provide the foundation for building a comprehensive clinic and home-based biologics asthma program. In addition, we offer insight into the barriers to implementing a successful program and strategies for overcoming them.

Knowledge, Attitudes, and Practices Among Patients with Systemic Lupus Erythematosus Toward Disease Management and Biologic Therapy

“…In cases where patients express discomfort with self-injection. 24 The implementation of a shared decision-making model has the potential to facilitate greater patient engagement and proactive involvement in the management of disease.…”

Immunobiological therapy in the treatment of severe asthma

“…Furthermore, this group also had a 32% relative reduction in the rate of exacerbations (Bel, 2014) When it comes to adverse reactions, in the MENSA and SIRIUS studies, around 2% of patients abandoned the clinical trial due to such events. The most common reactions were headache, reactions at the injection site, back pain and fatigue, with these events being reported mainly between the days of administration of the immunobiological (Miyokawa, 2020).…”

Real-World Experience on the Use of Mepolizumab from the Severe Asthma Registry of the German Asthma Net (MepoGAN-Study)

“…9 For severe eosinophilic asthma, a comprehensive clinical trial program consisting of four randomized, double-blind, parallel-group clinical studies of between 24 and 52 weeks duration evaluated the efficacy and safety of mepolizumab. 10 The dose-ranging efficacy study DREAM 11 and the exacerbation reduction study MENSA 12 were accompanied by SIRIUS, 13 an oral corticosteroid-sparing study, and MUSCA, 14 a quality-of-life (QoL) study. COLUMBA, a 4.5-year-long extension study to DREAM, investigated the long-term safety and efficacy of mepolizumab.…”

“… 15 All these studies demonstrated that treatment with mepolizumab was well tolerated and resulted in a meaningful decrease in blood eosinophils and a significant reduction of intake/dosage of OCS, reduction of exacerbations, and, in one study, improvement of QoL. 10 Despite this convincing evidence, controlled studies are derived in a narrowly framed selected population with limited information for treatment implementation in a real-world environment. It is unknown whether these patients respond differently to therapy when compared with patients from controlled trials.…”