Assessing the Efficacy of Mepolizumab in Asthma, COPD
Research Presented at CHEST 2024 reported on how mepolizumab can improve asthma control, and reduce exacerbations of concurrent asthma and COPD.
Mepolizumab (Nucala) is a monoclonal antibody that targets interleukin-5 (IL-5) and has been developed for the treatment of multiple diseases associated with type 2 inflammation. It was first approved by the FDA in 2015 to treat patients aged 12 years and older with severe asthma with an eosinophilic phenotype.1
Assessing the Efficacy of Mepolizumab in Asthma, COPD / Pixel-Shot - stock.adobe.com
Two research posters recently reported on how mepolizumab can improve asthma control, and reduce exacerbations of concurrent asthma and chronic obstructive pulmonary disease (COPD). The posters were presented at the annual meeting of the American College of Chest Physicians, CHEST 2024, held October 6 to 9 in Boston, Massachusetts.
READ MORE: Prednisone Superior to Other Corticosteroids for Patients with COPD, Heart Failure
In the first poster, researchers reported on 2-year data from the global, prospective, single-arm, observational cohort study REALITI-A.2 The study, which aimed to confirm the effectiveness of mepolizumab in the routine clinical care of patients with severe asthma, enrolled 822 patients who were newly prescribed 100 mg monthly mepolizumab. The Asthma Control Questionnaire (ACQ)-5 was used to determine the level of asthma control at baseline and at month 24.
The study found 781 patients had a baseline ACQ-5 assessment with a least square (LS) mean score of 2.87. Of 194 patients who completed the ACQ-5 at Month 24, the LS mean score was 1.33, indicating a mean change of -1.53. A minimal clinically important difference was achieved on average in all baseline blood eosinophil counts of 579 patients with available data at month 3 and was sustained through month 24. Baseline ACQ-5 of less than 1 was significantly associated with ACQ-5 of less than 1 at month 24. However, 44% of patients achieved ACQ-5 of less than 1 at Month 24 from an ACQ-5 of 1 or more at baseline.
At baseline, the presence of nasal polyps, absence of depression/anxiety, and absence of obesity were significantly associated with achieving ACQ-5 of less than 1 at Month 24. Use of maintenance oral corticosteroid, comorbid COPD, and comorbid gastroesophageal reflux disease at baseline was associated with preventing patients from reaching ACQ-5 of less than 1 at Month 24, although it was not significant.
“These data support use of mepolizumab in real-world clinical practice in patients with severe asthma, demonstrating sustained disease control in this heterogenous patient population,” the authors concluded.
In the second poster, investigators conducted a retrospective, longitudinal study to assess the real-world impact of mepolizumab initiation in patients with asthma and concurrent COPD.3 Data for the study was gathered from the Komodo Research claims database from January 2016 to June 2023. The study cohort included 2106 patients with asthma and concurrent COPD, and 4674 patients with only asthma.
Patients were included if they were 12 years of age or older, had 2 or more records of mepolizumab, and had 12 or more months of continuous insurance coverage before and after the index date. The main study outcome was annualized rates of COPD exacerbations, which included moderate and severe exacerbation.
The study found the annualized rate of COPD exacerbations in patients with concurrent asthma and COPD was 1.88 ± 1.96 before the introduction of mepolizumab. The rate decreased by 55% after the medication was introduced. The annualized rate of severe COPD exacerbations also decreased by 52%. Additionally, a significant reduction in asthma exacerbation was observed among patients with concurrent diagnosis of asthma and COPD, as well as among patients with asthma alone.
“These findings demonstrate the benefits of mepolizumab in reducing COPD and asthma exacerbation events in patients with asthma and concurrent COPD,” the authors concluded.
Be sure to stay up to date with all our CHEST 2024 coverage here.
Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.
