Mepolizumab Improves QoL in Comorbid Asthma and Upper Airway Disease

This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology annual meeting, taking place in San Francisco, California. Our staff will report on medical research related to asthma, allergy, and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI 2019.

SAN FRANCISCO — Mepolizumab was associated with improvements in asthma control and quality of life, as well as reductions in disease exacerbations in patients with comorbid severe asthma and upper airway disease, according to study results presented at the 2019 Annual Scientific Meeting of the American College of Allergy, Asthma, and Immunology (AAAAI) held February 22-25, 2019 in San Francisco, California.

“[Patients with] severe asthma have a higher prevalence of comorbid upper airway diseases which is associated with difficulty in achieving asthma control, reduced quality of life, and higher risk of exacerbation,” the researchers wrote.

The researchers performed a meta-analysis of 4 phase 2b/3 clinical trials (DREAM, MENSA, SIRIUS, and MUSCA), all of which included patients with severe asthma who participated in a mepolizumab treatment phase. Patients were assessed regarding their self-reported history of comorbid upper airway disease, including allergic rhinitis, sinusitis, or nasal polyposis. Several outcomes were compared between mepolizumab and placebo, including Asthma Control Questionnaire (ACQ), St. George’s Respiratory Questionnaire (SGRQ), and exacerbations, in patients with severe asthma both with and without comorbid upper airway disease.

Of the patients in the pooled analysis, 59% self-reported ≥1 upper airway comorbidity. Allergic rhinitis was the most frequently reported comorbidity in the final cohort. Treatment with mepolizumab in patients with comorbid upper airway disease was associated with a 0.35 (95% CI, 0.23-0.48) improvement in asthma control, according to the ACQ score. Mepolizumab was also associated with a pooled 7.5-point improvement in the SGRQ (95% CI, 5.2-9.8).

Overall, the use of mepolizumab resulted in a 51% reduction in exacerbations vs placebo (risk ratio [RR], 0.49; 95% CI, 0.41-0.58). In patients with severe asthma and without comorbid upper airway disease, mepolizumab was also associated with a 45% reduction in exacerbation compared with placebo (RR, 0.55; 95% CI, 0.44-0.69), as well as an improvement in the ACQ and SGRQ scores (0.29 points; 95% CI, 0.14-0.44 and 6.1 points; 95% CI, 3.2-9.1), respectively.

Disclosures: The mepolizumab phase 2b/3 clinical trials were funded by GlaxoSmithKline.