Mepolizumab Improves Lung Function for Patients With Severe Eosinophilic Asthma

Illustration of the lungs
Illustration of the lungs
Although previous studies have demonstrated significant reduction in asthma exacerbations with mepolizumab, investigators sought to assess the medication's effect on morning peak expiratory flow.

This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology, taking place in Orlando, Florida. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI/WAO 2018.

ORLANDO — The use of mepolizumab 100 mg subcutaneously resulted in significant improvement in lung function in individuals with severe eosinophilic asthma, according to research presented at the 2018 joint congress of the American Academy of Allergy, Asthma & Immunology and the World Allergy Organization, held March 2-5, 2018, in Orlando, Florida.

Researchers conducted a post-hoc analysis of 2 randomized, double-blind, placebo-controlled trials (NCT01691521/NCT02281318) to evaluate the effect of mepolizumab 100 mg subcutaneously on morning peak expiratory flow (AM PEF). 

Improvement was experienced by patients receiving mepolizumab 100 mg once every 4 weeks (n=454)) vs placebo (n=456). All patients received high-dose inhaled corticosteroids plus at least 1 controller medication, experienced at least 2 exacerbations in the previous year, and blood eosinophils ≥150 cells/mL at screening or ≥300 cells/mL in the previous year.

The mepolizumab group had an improvement in AM PEF of approximately 26 L/min vs 4 L/min for those receiving placebo.  Participants were stratified by eosinophil thresholds; the mean difference was 24 L/min (≥150 cells/mL), 27 L/min (≥300 cells/mL), and 34 L/min (≥500 cells/mL) (P<.001 for all subgroups) from the placebo group.  The group with <150 cells/mL increased 13 L/min, while the 150 to <300 cells/mL and 300 to <500 cells/mL groups demonstrated changes of 19 L/min and 17 L/min, respectively, compared with placebo.

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“Our analysis showed significant improvements with mepolizumab 100 mg SC in lung function measured by AM PEF in patients with severe eosinophilic asthma,” the investigators concluded.  They also noted that “higher eosinophil counts are associated with greater improvements in AM PEF.”

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Reference

Ortega H, Menzies-Gow A, Llanos-Aackert JP, et al. Improvement of lung function measured by AM PEF in patients with severe eosinophilic asthma treated with mepolizumab: a combined analysis of the MENSA and MUSCA studies. Presented at: AAAAI 2018/WAO Joint Congress; March 2-5, 2018; Orlando, FL. Abstract 49.