Reslizumab May Improve Outcomes, Reduce Health Care Use in Eosinophilic Asthma

In patients with eosinophilic asthma, treatment with intravenous (IV) reslizumab is associated with improved clinical and patient-reported outcomes, along with significant reductions in asthma-related health care resource utilization (HRU). Researchers conducted a retrospective study using patient-level data obtained via center-based and panel-based physician chart review. Results of the analysis were published in the journal CHEST.

The investigators sought to evaluate real-world outcomes linked to the use of IV reslizumab in individuals with severe eosinophilic asthma in US clinical practice. To be eligible to participate in the study, patients needed to have available medical records and a treatment history for at least 6 months pre-reslizumab treatment initiation (index date) to at least 7 months pre-reslizumab treatment initiation.

The primary study objective was to assess the proportion of patients responding to reslizumab therapy, based on a 4-category predefined measure that was developed by a committee of clinical experts. All participants were classified into 1 of 4 treatment response categories: (1) excellent response; (2) clinically meaningful response; (3) partial response; or (4) nonresponse/treatment failure. Those participants who were categorized as partial response were further categorized into the following nonmutually exclusive subgroups: (1) therapeutic response; (2) physiologic response; and (3) patient-reported outcome response.

The secondary study objective was to describe clinical and economic outcomes associated with reslizumab. Secondary outcomes included the following parameters, both pre-reslizumab initiation and post-reslizumab initiation: rate of clinical asthma exacerbations; oral corticosteroid use; measures of lung function (ie, forced expiratory volume in 1 second [FEV₁] percent predicted, forced vital capacity [FVC], FEV₁/FVC ratio); patient-reported asthma control (Asthma Control Test [ACT]); blood eosinophil levels; reslizumab treatment discontinuation; and  asthma-related HRU.

A total of 215 patient charts obtained from December 4, 2018, through March 8, 2019, were included. Overall, 58.6% of participants exhibited an excellent response, 16.3% had a clinically meaningful response, 21.9% experienced a partial response, and 3.3% were considered to be nonresponders/experienced treatment failure.

In a 6-month period, there was a significant decrease in the proportion of patients who experienced a clinical asthma exacerbation (from 86.0% to 40.5%; P <.001). In fact, the mean number of clinical asthma exacerbations per patient was reduced significantly from 2.84±2.41 pre-reslizumab initiation to 0.94±1.86 post-reslizumab initiation (P <.001). Furthermore, improvements were reported in FEV₁ percent predicted (65.1%±20.5% vs 73.1%±23.1%, respectively; P <.001) and ACT scores (13.8±4.2 vs 18.6±4.0, respectively; P <.001) from pre-reslizumab initiation to post-reslizumab initiation. Additionally, significant decreases in asthma-related HRU were observed post-reslizumab initiation.

The investigators concluded that this analysis — the largest real-world study of reslizumab to date, as well as one of the largest real-world evidence studies of any interleukin-5 antagonist — demonstrates that IV reslizumab is associated with improvements in clinical outcomes and patient-reported outcomes, and significant reductions in asthma-related HRU over the course of 6 months. Additional evidence suggests that these improvements are maintained over 12 months. The findings from this study complement those from IV reslizumab phase 3 trials.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Wechsler ME, Peters SP, Hill TD, et al. Clinical outcomes and healthcare resource utilization associated with reslizumab treatment in adults with severe eosinophilic asthma in real-world practice. CHEST. Published online December 14, 2020. doi:10.1016/j.chest.2020.11.060