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Efficacy of mepolizumab in usual clinical practice and characteristics of responders
Respiratory Medicine  (IF3.415),  Pub Date : 2021-09-02, DOI: 10.1016/j.rmed.2021.106595
Carlota Rodríguez-García, Marina Blanco-Aparicio, Juan José Nieto-Fontarigo, Nagore Blanco-Cid, Coral Gonzalez-Fernandez, Mar Mosteiro-Añon, Uxío Calvo-Alvarez, Luis Perez-De-Llano, María Dolores Corbacho-Abelaira, Tamara Lourido-Cebreiro, Luis Miguel Dominguez-Juncal, Carlos Crespo-Diz, Raquel Dacal-Quintas, Abel Pallares-Sanmartin, David Dacal-Rivas, Francisco Javier Gonzalez-Barcala

Background

Severe eosinophilic asthma is a high-burden disease. Mepolizumab has been effective in several randomized clinical trials. However, such success might not be applicable to patients treated in usual clinical practice. The objectives of this article are to evaluate the efficacy of mepolizumab in severe uncontrolled eosinophilic asthma under usual clinical practice, and to determine characteristics associated with the response to this treatment.

Methods

We have conducted a retrospective, multicentre study, including all adult patients with severe uncontrolled eosinophilic asthma in Galicia, Spain, on whom mepolizumab treatment was started before June 2020, at least 6 months before the time of inclusion, and had received at least one dose of the drug. Patient characteristics, clinical data, respiratory function and comorbidities were collected at baseline and at the 6-month-follow-up. Responders and super-responders were defined according to clinical response and requirement of systemic corticosteroids.

Results

122 patients (mean age 58 years old) were included. In the follow-up treatment 6 months later, 75.4% of the patients were well-controlled, displaying a significant reduction in blood eosinophil counts (p < 0.001), hospital admissions and disease exacerbations (p < 0.001), and had their systemic glucocorticosteroid dose significantly reduced (p < 0.001). The inhaled corticosteroid dose was also lowered (p < 0.01) after 6 months of treatment. Around two-thirds had a clinically significant increase in FEV1, 95% of the patients were considered responders and 43% super-responders.

Conclusion

In routine clinical practice, mepolizumab is effective in patients with severe eosinophilic asthma and it has a good safety profile.