Abstract
Introduction and Aim: To describe the patient characteristics and response to mepolizumab, a monoclonal anti-interleukin 5 antibody for the treatment of severe eosinophilic asthma.
Methods: An Australian post-marketing surveillance registry (AMR) was established. Patients prescribed mepolizumab were characterised at baseline and after treatment. Asthma control (ACQ5) and quality of life (Juniper AQLQ) were assessed. Responders had a reduction in ACQ5 score of ≥0.5 or in maintenance oral corticosteroid (OCS) dose.
Results: Between January 2017 and June 2018, 212 registered patients commenced mepolizumab. Patients were a median(Q1,Q3) age of 60(49,68) years and 54% were female. 62% were never-smokers, 46% were obese and 63% atopic. Asthma duration was 26(13,43) years and 48% of patients were taking maintenance OCS. During the 12 months prior, they had required a median of 3(2,6) OCS courses and 28% had been hospitalised for exacerbations.
After 3-5 months of mepolizumab treatment, median peripheral blood eosinophil (PBE) level reduced [0.6(0.4,0.8) to 0.1(0.02,0.1)x109/L], mean post-bronchodilator FEV1%predicted improved [60.8±19.4(SD) to 65.7±22.7], quality of life improved [median AQLQ score 3.7(2.9,4.7) to 5.1(4.3,6.1)] and mean ACQ5 score reduced [3.54±0.90 to 1.79±1.13] (all p<0.0001).
At 6-8 months (n=120 assessable), 88% of patients were classified as ACQ5 responders and 12% had ceased mepolizumab. 53% of patients still had an ACQ5 score of ≥1.5 at this point.
Conclusions: Patients with severe eosinophilic asthma in Australia have a very significant symptom burden and disease impact. Targeted anti-IL-5 treatment effectively reduced this burden. Despite improvement, more than half remain uncontrolled.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA541.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019