Reslizumab: Real-World Effect on Eosinophilic Asthma Exacerbations, OCS

A real-world study found reslizumab reduces severe asthma exacerbations and oral corticosteroid (OCS) use in patients with severe eosinophilic asthma, both in biologic-naïve reslizumab initiators and in those who switched from another type-2 biologic. These findings, recently published in The Journal of Allergy and Clinical Immunology: In Practice, confirmed previous findings of randomized controlled trials (RCTs) of reslizumab.

Reslizumab is a biologic targeting interleukin-5 that has been shown in RCTs to reduce asthma exacerbations and have an OCS-sparing effect as an add-on therapy in patients with severe eosinophilic asthma. However, real-world evidence is scarce concerning the effectiveness of reslizumab. Additionally, little is known regarding the effect of reslizumab on patients who are biologic-naïve vs on those who switch to reslizumab from another biologic, something that happens frequently in real-world practice.

To obtain this real-world data, researchers conducted an observational study of 134 adults with severe eosinophilic asthma from a Dutch severe asthma registry who had initiated reslizumab treatment (4 weekly infusions, 0.3 mg/kg) before April 2020 and had follow-up data for at  least 6 months. Participants included biologic-naïve patients who initiated reslizumab (n=56) and patients who switched from another type-2 biologic (n=78). In addition to comparing data from patients on exacerbations, OCS use, and lung function collected before and after initiation of reslizumab, the researchers also had patients complete the Asthma Control Questionnaire and Asthma-Related Quality of Life Questionnaire every 3 months. The investigators also conducted a one-time survey of clinical asthma experts with reslizumab treatment experience (n=10).

The researchers found that reslizumab add-on treatment significantly reduced the rate of asthma exacerbations, the proportion of patients on maintenance oral corticosteroids, and the dosage level for maintenance OCS, with comparable reductions were found both in patients who were biologic-naïve and in those who switched from another biologic therapy. In their analysis of survey data, the researchers found that 59.2% of patients rated their response to reslizumab as “good” or “excellent,” whereas 90% of physicians surveyed reported being “satisfied” or “very satisfied” with reslizumab, with 80% of physicians reporting reslizumab “to be of added value over the other biologics,” said study authors.

The researchers concluded, “This real-world study confirmed the beneficial effects of reslizumab when given to patients as their first add-on treatment, but also demonstrated additive effectiveness in patients switching from another type-2 biologic, which was confirmed by physicians.”

Disclosure: This research was supported by an unrestricted grant from GSK, Novartis Pharma, AstraZeneca, Teva and Sanofi- Genzyme Regeneron. An additional unrestricted grant was received from Teva for this study. Please see the original reference for a full list of disclosures.

Reference

Hashimoto S, Kroes JA, Eger K, et al; RAPSODI team. Real-world effectiveness of reslizumab in patients with severe eosinophilic asthma – “first initiators” and “switchers”. J Allergy Clin Immunol Pract. Published online on April 25, 2022. doi:10.1016/j.jaip.2022.04.014