Real-world effectiveness of mepolizumab in patients with severe asthma and associated comorbidities

Abstract

Background: Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management. Objective: To describe the real-world effectiveness of mepolizumab in patients with severe asthma stratified by common overlapping comorbidities. Methods: This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had more than or equal to 1 claim (excluding claims for diagnostic tests) with a diagnosis code for more than or equal to 1 of 7 comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month preindex baseline period; these were used to stratify patients into 7 nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related health care resource utilization during the 12-month baseline and follow-up periods. Each patient acted as their own control. Results: Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all 7 comorbidity subgroups, there were significant (P < .05) reductions of 38% to 55% and 57% to 83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up vs baseline period, except for exacerbations requiring hospitalization in the nasal polyp subgroup, owing to the small subgroup sample size. During the follow-up vs baseline periods, mean number of oral corticosteroids claims was significantly (P < .001) reduced by 29% to 38%; 39% to 47% of patients achieved greater than or equal to 50% oral corticosteroids dose reduction. Significant reductions in exacerbationrelated health care resource utilization were also observed. Conclusion: Mepolizumab treatment provided real-world clinical benefits in patients.

REALITI-A Study: Real-World Oral Corticosteroid-Sparing Effect of Mepolizumab in Severe Asthma

“…8,9,24,25 Finally, mepolizumab was effective in several retrospective real-world studies conducted in broader, less homogeneous, severe asthma populations that more closely reflect patients seen in clinical practice. 6,[26][27][28][29][30][31][32][33] However, more robust real-world evidence from prospective, observational studies is needed 34 that assesses the occurrence and magnitude of oral corticosteroid (OCS)-sparing effects in severe asthma.…”

Challenges in severe asthma: Do we need new drugs or new biomarkers?

“…Comorbid nasal polyposis has been shown to predict response to mepolizumab ( 59 ) and benralizumab ( 60 ). However, in a real-world effectiveness study of mepolizumab, comorbidities did not correlate with mepolizumab effectiveness ( 61 ).…”

A rational approach to compare and select biologic therapeutics in asthma

“…Various realworld studies have corroborated RCT results in terms of reduction of exacerbations, 36,37 OCS-sparing effects, 37,38 in addition to revealing efficacy in people with asthma with various comorbidities to include chronic sinusitis, allergic rhinitis, atopic dermatitis, and obesity. 39 There are long-term data supporting the safety of mepolizumab in SEA. The COLUMBA study evaluated 347 patients who were enrolled for an average of 3.5 years.…”