TY - JOUR T1 - Late-breaking abstract: Oral corticosteroid-sparing effect of mepolizumab in severe eosinophilic asthma: The SIRIUS study JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 2907 AU - EH Bel AU - SE Wenzel AU - PJ Thompson AU - CM Prazma AU - O Keene AU - SW Yancey AU - H Ortega AU - ID Pavord Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/2907.abstract N2 - Background: There is an unmet treatment need in a sub-population of severe asthma patients who, despite the use of maximal inhaled therapy, require regular treatment with oral corticosteroids (OCS).Objective: To study the steroid-sparing effect of mepolizumab in severe eosinophilic asthma.Methods: We conducted a randomized, double-blind placebo controlled trial of mepolizumab (n=69) administered as monthly injections of 100mg subcutaneously for 6 months vs placebo (n=66) in patients with severe, OCS dependent asthma, whose treatment was optimized prior to randomization.Results: Patients on mepolizumab 100mg SC achieved greater reductions in OCS dose compared to placebo (p=0.008); 54% (37/69) of mepolizumab patients achieved ¡Ý50% reduction in OCS dose compared to 33% (22/66) of placebo patients. The median reduction from baseline OCS dose was 50% with mepolizumab compared to 0% with placebo (p=0.007). Despite the lower OCS dose patients on mepolizumab had a 32% reduction in the rate of exacerbations (1.44 vs 2.12/year; p=0.042), and fewer exacerbations resulting in hospital admission (0 vs 7). The mean reductions in ACQ and SGRQ with mepolizumab compared to placebo were 0.52, (p=0.004) and 5.8 (p=0.019). The safety profile of mepolizumab was similar to placebo.Conclusions: Mepolizumab had a significant oral steroid-sparing effect and reduced the frequency of exacerbations. Mepolizumab also resulted in significant improvements in asthma control and quality of life, despite a reduced OCS dose. Treatment with mepolizumab in this population with significant impairment and high risk for side effects from OCS provides an important therapeutic alternative.Funding: GSK MEA115575-NCT01691508. ER -