RT Journal Article
SR Electronic
T1 Late Breaking Abstract - Efficacy of oral prednisolone in patients with stable severe eosinophilic asthma (SEA) treated with Mepolizumab
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2251
DO 10.1183/13993003.congress-2020.2251
VO 56
IS suppl 64
A1 Yang, Jieqiong
A1 Busby, John
A1 Heaney, Liam G
A1 Brightling, Chris E
A1 Pavord, Ian D
A1 Borg, Katie
A1 Mcdowell, Pamela Jane
A1 Diver, Sarah
A1 Shrimanker, Rahul
A1 Smith, Steven
A1 Shepherd, Malcolm
A1 Lee, Waiting Nicola
A1 Chaudhuri, Rekha
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/2251.abstract
AB Background: Mepolizumab and prednisolone have overlapping anti-inflammatory effects so the clinical effects of prednisolone might be absent in stable patients on treatment with mepolizumab.Methods: We tested this hypothesis in a randomized, double-blind, placebo-controlled, crossover trial of prednisolone (0.5mg/kg/day for 2 weeks) after ≥12 weeks of mepolizumab.Results: Blood and sputum eosinophil count decreased post-prednisolone (-0.02x109/L, p=0.003; -10.5x109/L, p=0.004); differences compared to placebo were -0.02x109/L (p<0.001) and -6.5x109/L (p=0.002), respectively. Sputum eosinophil % of total reduced by 2.0% post-prednisolone (p=0.004). Compared to placebo, FeNO reduced by 13ppb post-prednisolone (p=0.001). A small between group difference was measured in FEV1 and FEF25-75 (0.1L, p=0.019; 0.2L, p=0.006). ACQ-5, VAS, mini-AQLQ and SGRQ did not change post-prednisolone.Conclusions: In patients with SEA treated with mepolizumab, prednisolone has no significant effects on symptoms or QoL but improves FEV1 and small airway function and reduces FeNO, potentially reflecting suppression of persisting IL-4/IL-13 pathways. View this table:Table 1 Difference in measures of prednisolone & placebo response.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2251.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.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).