Mepolizumab Shows Real-World Efficacy in Allergic and Non-Allergic Asthma

Mepolizumab use significantly reduced the use of oral corticosteroids and substantially reduced exacerbations in patients with both allergic and non-allergic asthma. These were among the findings of a real-world study presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2022 Annual Scientific Meeting, held from November 10 to 14, in Louisville, Kentucky.

Although the efficacy and safety of mepolizumab for treating patients with severe asthma is well-documented, investigators sought to establish the therapy’s comparative effectiveness for treating those with non-allergic and allergic asthma.

The researchers conducted a retrospective cohort study using claims data from the Optum Research Database for 538 patients at least 6 years of age who initiated mepolizumab treatment for asthma between January 2016 and December 2019. Investigators identified 298 (55.4%) patients with non-allergic asthma and 240 (44.6%) patients with allergic asthma, using diagnosis codes, lab test results, and medication history to identify patients’ allergic status.

The researchers analyzed patients’ oral corticosteroid (OCS) use and asthma exacerbation rate in the baseline period (12 months before mepolizumab initiation) and in the follow-up period (12 months following initiation). The analysis of exacerbations found a substantial reduction in the mean (SD) rate of asthma exacerbations from baseline to follow-up for patients with non-allergic asthma (2.51 [2.17] to 1.70 [1.92]; P <.001) and for patients with allergic asthma (3.19 [2.49] to 2.10 [2.12]; P <.001). The analysis of OCS use showed a significant reduction from baseline to follow-up in the mean (SD) count of OCS claims for patients with non-allergic asthma (5.46 [4.12] to 3.20 [3.69]; P <.001) and for patients with allergic asthma (5.19 [4.47] to 3.46 [4.50]; P <.001).

No significant differences were found in asthma exacerbation rates or counts of OCS claims from baseline to follow-up between cohorts.

“This study supports the real-world effectiveness of mepolizumab for the treatment of severe asthma with allergic and non-allergic phenotypes,” investigators concluded.