Mepolizumab Improves QoL in Severe Asthma and Nasal Polyps, Allergic Rhinitis

After careful consideration, the American Academy of Allergy, Asthma & Immunology canceled its annual meeting that was to take place in Philadelphia, Pennsylvania from March 13 to 16, because of concerns regarding the coronavirus disease 2019 (COVID-19) outbreak. Although the live events will not proceed as planned, our readers can still find coverage of research that was scheduled to be presented at the meeting.

Treatment with mepolizumab is associated with improvements in asthma exacerbation rates and health-related quality of life in patients with severe eosinophilic asthma and comorbid nasal polyps (NP), sinusitis, or allergic rhinitis (AR), according to findings intended to be presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting.

The researchers performed a pooled, post hoc meta-analysis of data from the DREAM (ClinicalTrials.gov Identifier: NCT01000506), MENSA (ClinicalTrials.gov Identifier: NCT01691521), SIRIUS (ClinicalTrials.gov Identifier: NCT01691508), and MUSCA (ClinicalTrials.gov Identifier: NCT02281318) trials. A total of 1189 patients aged ≥12 years with severe eosinophilic asthma and concomitant NP, sinusitis, or AR received mepolizumab, and 689 patients received placebo. Rates of clinically significant exacerbations, defined as a worsening of asthmatic symptoms that required treatment systemic corticosteroids and/or hospitalization or emergency room visits, was assessed. In addition, the mean change from baseline in the St George’s Respiratory Questionnaire total scores was also evaluated after treatment.

In patients with and without NP, the rates of clinically significant exacerbations improved by 68% with mepolizumab compared with placebo (rate ratio [RR], 0.32; 95% CI, 0.24-0.45). A comparison between patients who received mepolizumab and those who received placebo also demonstrated a 49% improvement in the rates of clinically significant exacerbations in patients with and without sinusitis (RR, 0.51; 95% CI, 0.36-0.73), as well as by 50% in patients with and without AR (RR, 0.50; 95% CI, 0.41-0.61). There were minimally important differences in terms of mean questionnaire score improvements with mepolizumab vs placebo in patients with NP (11.3), with sinusitis (8.6), and with AR (8.0).

In addition to the main findings, the researchers added that improvements in both exacerbations and quality of life were largest in patients with NP.

Disclosure: This clinical trial was supported by GlaxoSmithKline. Please see the original reference for a full list of authors’ disclosures.

Reference

Jain N, Siri D, Yancey S, et al. Mepolizumab reduces exacerbations and improves health-related quality of life in patients with severe asthma and nasal polyps, sinusitis, or allergic rhinitis. J Allergy Clin Immunol. 2020;145(Suppl 2):AB26. 

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