The use of mepolizumab add-on therapy demonstrated efficacy and safety in a real-world cohort of patients with severe eosinophilic asthma. A retrospective, observational, longitudinal study (the Mepolizumab Experience in the Netherlands [MOMENT]) was performed in a group of patients with severe eosinophilic asthma who were treated with mepolizumab in a tertiary referral center for severe asthma. Results of the analysis were published in the Journal of Asthma.

Recognizing that only data from randomized controlled trials are available and that real-world data are lacking, investigators sought to examine outcomes in a real-world cohort of patients with severe eosinophilic asthma who received mepolizumab therapy. The primary study objective was to establish participants’ response rates, which were based on a global evaluation of therapeutic effectiveness by the treating pulmonologist. Secondary objectives included the assessment of asthma frequency, use of systemic maintenance glucocorticoids, Asthma Control Questionnaire (ACQ), adverse events, and lung function.

A total of 78 patients were enrolled in the study. The mean patient age was 54 years (range, 20-83 years); 69.2% of the participants were women. Mepolizumab treatment was considered to be beneficial, and thus was continued in 75.6% of the participants at 12 months from the initiation of therapy. Insufficient response was cited as the most common reason for treatment discontinuation.

At 12 months from the onset of therapy, a significant decrease of 3.2 in severe asthma exacerbations per patient year was reported compared with the number of severe exacerbations in the year before initiation of mepolizumab therapy (95% CI, 2.5-4.1; P <.001). Moreover, the mean number of hospital admissions resulting from an exacerbation of asthma was 0.35 per patient year (range, 0-5) during mepolizumab therapy compared with 0.77 (range, 0-10) in the year before mepolizumab therapy, which translates to a mean difference of 0.42 (95% CI, 0.17-0.68; P =.001).


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At 12 months from baseline, the ACQ was 0.80 points lower compared with baseline values (95% CI, 0.49-1.12; P <.001). In addition, patients who were treated with mepolizumab reported a significant increase of 3.7% (95% CI, 0.3%-7.2%; P =.034) of predicted forced expiratory volume in 1 second compared with baseline values. There were no serious adverse events reported with mepolizumab therapy.

The investigators concluded that the findings from the current study confirm that mepolizumab decreases the rate of severe asthma exacerbations and hospitalizations resulting from exacerbations, improves asthma control, reduces the use of maintenance systemic corticosteroids, and has a favorable safety profile in real-world practice.

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

Reference

Van Toor JJ, Van der Mark SC, Kappen JH, In ‘t Veen JCCM, Braunstahl GJ. Mepolizumab add-on therapy in a real world cohort of patients with severe eosinophilic asthma: response rate, effectiveness, and safety. J Asthma. 2020;1-8. doi:10.1080/02770903.2020.1723623