Efficacy of mepolizumab in usual clinical practice and characteristics of responders

Rodríguez‐García, Carlota; Blanco-Aparicio, Marina; Nieto‐Fontarigo, Juan José; Blanco-Cid, Nagore; González-Fernández, Coral; Mosteiro-Añón, Mar; Calvo-Álvarez, Uxío; Pérez-de-Llano, Luis; Corbacho, Diego Pereiro; Lourido-Cebreiro, Tamara; Dominguez-Juncal, Luis Miguel; Crespo-Diz, Carlos; Dacal-Quintas, Raquel; Pallarés-Sanmartín, Abel; Rivas, David Dacal; González‐Barcala, Francisco Javier

doi:10.1016/j.rmed.2021.106595

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…This effect is closely related to the mepolizumab-mediated improvement in asthma control. The results of our study are consistent with those of other studies [16][17][18][19][20]. In this study, we found that mepolizumab did not change IgE levels, which is in agreeance with the results of other studies [21,22].…”

Section: Discussionsupporting

confidence: 94%

Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma

Palacionyte,

Januskevicius,

Vasyle

et al. 2024

Diagnostics

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Anti-interleukin (IL) 5 is an effective treatment modality for inhibiting eosinophilic inflammation in patients with T2-high severe asthma. The aim of this study was to determine the clinical efficacy and serum levels of type 2 inflammatory mediators during 24 weeks of mepolizumab treatment in patients with T2-high severe asthma. Eighteen patients with T2-high severe asthma were enrolled in this study. All patients received 100 mg of mepolizumab subcutaneously every 4 weeks and were retested at 4, 12, and 24 weeks. A clinical examination, asthma control test (ACT), and spirometry were performed; fractional exhaled nitric oxide (FeNO) levels were evaluated; and blood samples were drawn at every visit. Type 2 inflammation mediator levels were measured using enzyme-linked immunosorbent assay (ELISA). The blood eosinophil level significantly decreased, the ACT score and FEV1 increased after 4 weeks of mepolizumab treatment with the same tendency after 12 and 24 weeks (p < 0.05), and the FeNO level did not change (p > 0.05). A total of 27.8% of patients reached clinical remission criteria after 24 weeks of mepolizumab treatment. IL-33 and eotaxin significantly increased (p < 0.05) while IL-5, IL-13, thymic stromal lymphopoietin (TSLP), soluble IL-5 receptor subunit alpha (sIL-5Rα), and soluble high-affinity immunoglobulin E receptor (sFcεRI) decreased, with the same tendency after 12 and 24 weeks (p < 0.05). The serum levels of immunoglobulin (Ig) E and IL-4 and IL-25 levels did not change during mepolizumab treatment compared to baseline (p > 0.05). In conclusion, treatment with mepolizumab over 24 weeks improved lung function and asthma control in T2-high severe asthma patients, with nearly one-third achieving clinical remission criteria, and affected the balance of type 2 inflammatory mediators.

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Section: Discussionsupporting

confidence: 94%

Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma

Palacionyte,

Januskevicius,

Vasyle

et al. 2024

Diagnostics

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“…Thirty-four out of our 70 patients (48.6%) fulfilled the criteria of super-responder: no exacerbations and no intake of oral corticosteroids. We have reported a higher figure of super-responders than Kavanagh (28.3%) [13] and Rodríguez-García (43%) [14]. Attending complete response (super-responder + ACT ≥20 + FEV1 ≥80%), 17 out of 70 patients (24.29%) fulfilled the criteria, a bit below the 30 9% reported by Cakmak et al [15].…”

Section: Discussionmentioning

confidence: 68%

Effectiveness of Mepolizumab in Patients with Severe Eosinophilic Asthma with/without Nasal Polyposis: A Real-Life Study

Bravo-Gutiérrez,

Miralles-López,

Valverde-Molina

et al. 2023

Int Arch Allergy Immunol

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Introduction: Asthma is one of the most common chronic diseases and affects around 334 million people worldwide. The estimated prevalence of severe asthma is 3–10% of the asthmatic population. Mepolizumab has demonstrated efficacy in reducing exacerbations, oral corticosteroid use, and improving quality of life, asthma control, and lung function in patients with severe eosinophilic asthma (SEA). Our study aimed to check the response to mepolizumab in a series of severe asthma patients regarding exacerbations, oral corticosteroid use, asthma control, quality of life, and lung function and to compare the response between patients with and without nasal polyps. Method: This is a retrospective, multicenter study of RE-ASGRAMUR (Register of Severe Asthma of the Region of Murcia) performed in eight hospitals of the Region of Murcia (Spain) under routine clinical practice conditions. We included patients diagnosed with SEA who completed at least 1 year of treatment with mepolizumab. We analyzed clinical characteristics, drug tolerance, and effectiveness: exacerbations, ACT, miniAQLQ, forced expiratory volume in 1 s (FEV1), and use of oral corticosteroids. We also compared the results between patients with and without nasal polyps. Results: The median of exacerbations before treatment was 3 and decreased to 0 after treatment (mean decrease of 77.4%). The median diary oral prednisone intake was 15 mg before treatment and 5 mg after treatment (mean 56% reduction). We have obtained a significant improvement in other variables: ED visits and hospitalizations, asthma control (ACT), quality of life (miniAQLQ), and lung function (FEV1). Thirty-four out of 70 patients (48.57%) fulfilled the criteria of super-responder, and 17 out of 70 (24.29%) had a complete response. More patients in the group with nasal polyps fulfilled the criteria of super-responder and complete response to mepolizumab. Conclusions: Mepolizumab is a safe and effective treatment for SEA patients, improving exacerbations, oral corticosteroid intake, asthma control, quality of life, and lung function. In patients with associated nasal polyposis, there is a statistically significant higher proportion of super-responders and complete responders.

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“…Recientemente se han publicado estudios en vida real que confirman los datos de eficacia de los estudios pivotales, así como seguridad y continuidad del tratamiento en un alto porcentaje de pacientes 154 , 155 , 156 .…”

Section: Tratamiento Del Asma Graveunclassified

Documento de consenso de asma grave en adultos. Actualización 2022

Álvarez-Gutiérrez

Aparicio

Maldonado

et al. 2022

Open Respiratory Archives

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Efficacy of mepolizumab in usual clinical practice and characteristics of responders

Cited by 8 publications

References 24 publications

Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma

Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma

Effectiveness of Mepolizumab in Patients with Severe Eosinophilic Asthma with/without Nasal Polyposis: A Real-Life Study

Documento de consenso de asma grave en adultos. Actualización 2022

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