Mepolizumab Reduces Exacerbations in Patients with Asthma, Comorbid Conditions

By Jeff Craven /alert Contributor
Save to PDF By

Asthma patients with comorbid conditions such as nasal polyps, sinusitis, or allergic rhinitis had a reduced number of exacerbations and better health-related quality of life after receiving mepolizumab, according to recent research released as an abstract for the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting.

Mepolizumab is an interleukin-5 (IL-5) antagonist monoclonal antibody which was approved in 2015 by the FDA to treat severe eosinophilic asthma. It recently won approval in September 2019 from the FDA for treating children as young as 6 years old with severe eosinophilic asthma, and was approved in March 2020 in Canada as an add-on therapy for adults with severe eosinophilic asthma. It has been licensed as an autoinjector for use by clinicians to administer in doses between 1 and 4 weeks, or as a pre-filled safety syringe to be injected at home by a caregiver.

“Mepolizumab reduces rates of severe asthma exacerbations in patients with type 2 high eosinophilic inflammation,” Neal Jain, MD, of San Tan Allergy & Asthma in Gilbert, Arizona, and colleagues wrote in their study abstract. “We examined the impact of mepolizumab on clinically significant exacerbations and health-related quality of life (HRQoL) in patients with severe eosinophilic asthma and upper respiratory comorbidities.”

Jain and colleagues performed a pooled, post-hoc analysis of patients with severe eosinophilic asthma in the DREAM, MENSA, SIRIUS, and MUSCA trials. Overall, 1,189 patients in the trials received mepolizumab, while 689 patients received placebo. Patients recruited in the trials were adolescents older than 12 years old with nasal polyps (NP), sinusitis, or allergic rhinitis (AR). The researchers examined the mean change in number of clinically significant exacerbations from baseline using the St. George’s Respiratory Questionnaire (SGRQ) total score. 

The results showed mepolizumab improved clinically significant exacerbations by 68% in patients with NP (rate ratio, 0.32; 95% confidence interval, 0.24-0.45) and 44% in patients without NP (RR, 0.56; 95% CI, 0.48-0.65) compared with placebo. Among patients with (RR, 0.51; 95% CI, 0.36-0.73) and without sinusitis (RR, 0.51; 95% CI, 0.44-0.59), 49% experienced improved exacerbation symptoms compared with placebo. Patients with (RR, 0.50; 95% CI, 0.41-0.61) and without (RR, 0.50; 95% CI, 0.41-0.61) allergic rhinitis had a 50% improvement in exacerbation symptoms compared with placebo.

Minimally important differences in mean SGRQ scores favored patients with (11.3) and without NP (6.0), with (8.6) and without sinusitis (6.3), and with (8.0) and without AR (6.1) compared with placebo, favoring the mepolizumab group, the researchers said, with the largest exacerbation and QoL improvements seen in the NP comorbidity group.

“Patients with severe eosinophilic asthma and comorbid NP, sinusitis, or AR demonstrated marked improvements in clinically significant asthma exacerbation rates and HRQoL following mepolizumab treatment; these improvements were similar or numerically greater than those experienced by patients without these comorbidities,” Jain and colleagues concluded.

 

© 2024 /alert® unless otherwise noted. All rights reserved.
Reproduction in whole or in part without permission is prohibited.
Privacy Policy | Terms of Use | Editorial Policy | Advertising Policy