- Title
- Mepolizumab effectiveness and identification of super-responders in severe asthma
- Creator
- Harvey, Erin S.; Langton, David; Katelaris, Constance; Stevens, Sean; Farah, Claude S.; Gillman, Andrew; Harrington, John; Hew, Mark; Kritikos, Vicky; Radhakrishna, Naghmeh; Bardin, Philip; Peters, Matthew; Reynolds, Paul N.; Upham, John W.; Baraket, Melissa; Bowler, Simon; Bowden, Jeffrey; Chien, Jimmy; Chung, Li Ping; Grainge, Christopher; Jenkins, Christine; McDonald, Vanessa M.; Wark, Peter A. B.; Gibson, Peter G.
- Relation
- European Respiratory Journal Vol. 55, Issue 5, no. 1902420
- Publisher Link
- http://dx.doi.org/10.1183/13993003.02420-2019
- Publisher
- European Respiratory Society
- Resource Type
- journal article
- Date
- 2020
- Description
- Severe asthma is a high-burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population. The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia. Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58% female) commenced mepolizumab. They had poor symptom control (median Asthma Control Questionnaire (ACQ)-5 score of 3.4), frequent exacerbations (median three courses of oral corticosteroids (OCS) in the previous 12 months), and 47% required daily OCS. Median baseline peripheral blood eosinophil level was 590 cells·μL−1. Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%. Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95% CI 0.29–0.41); p<0.001) and hospitalisations (rate ratio 0.46 (95% CI 0.33–0.63); p<0.001). Treatment improved symptom control (median ACQ-5 reduced by 2.0 at 6 months), quality of life and lung function. Higher blood eosinophil levels (p=0.003) and later age of asthma onset (p=0.028) predicted a better ACQ-5 response to mepolizumab, whilst being male (p=0.031) or having body mass index ⩾30 (p=0.043) predicted a lesser response. Super-responders (upper 25% of ACQ-5 responders, n=61, 24%) had a higher T2 disease burden and fewer comorbidities at baseline. Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.
- Subject
- severe asthma; mepolizumab; patients; treatment; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1436725
- Identifier
- uon:40118
- Identifier
- ISSN:0903-1936
- Language
- eng
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Goal 3: Good Health and Well-Being
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