Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22744
Title: Mepolizumab effectiveness and identification of super-responders in severe asthma.
Authors: Harvey, Erin S;Langton, David;Katelaris, Constance;Stevens, Sean;Farah, Claude S;Gillman, Andrew;Harrington, John;Hew, Mark;Kritikos, Vicky;Radhakrishna, Naghmeh;Bardin, Philip;Peters, Matthew;Reynolds, Paul N;Upham, John W;Baraket, Melissa;Bowler, Simon;Bowden, Jeffrey;Chien, Jimmy;Chung, Li Ping;Grainge, Christopher;Jenkins, Christine;Katsoulotos, Gregory P;Lee, Joy;McDonald, Vanessa M;Reddel, Helen K;Rimmer, Janet;Wark, Peter A B;Gibson, Peter G
Affiliation: Lung research, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
Austin Health, Heidelberg, Victoria, Australia
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
Monash University, Melbourne, VIC, Australia
Department of Respiratory Medicine, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia
Department of Thoracic Medicine, Concord Hospital, Concord, NSW, Australia
Lung and Sleep Medicine, Monash University and Medical Centre, Clayton, VIC, Australia
Respiratory Department, St Vincent's Hospital, Melbourne, VIC, Australia
Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, VIC, Australia
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
Immunology and Allergy Unit, Campbelltown Hospital, Campbelltown, NSW, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
Department of Thoracic Medicine, Frankston Hospital, Frankston, VIC, Australia
Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
Woolcock Institute of Medical Research, Glebe, NSW, Australia
St Vincent's Clinic, Darlinghurst, NSW, Australia
St George Specialist Centre, Kogarah, NSW, Australia
St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
Concord Clinical School University of Sydney, Concord, NSW, Australia
Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
Department of Sleep and Respiratory Medicine, Westmead Hospital, Westmead, NSW, Australia
School of Medicine, The University of Sydney, NSW, Australia
Respiratory and Sleep Services, Flinders Medical Centre and Flinders University, Bedford Park, SA, Australia
Department of Respiratory Medicine, Mater Hospital Brisbane, South Brisbane, QLD, Australia
South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
Issue Date: 5-Mar-2020
EDate: 2020
Citation: The European respiratory journal 2020; online first: 5 March
Abstract: Severe asthma is a high burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population.The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia.Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58% female) commenced mepolizumab. They had poor symptom control [median Asthma Control Questionnaire (ACQ)-5 score of 3.4], frequent exacerbations [median 3 courses of oral corticosteroids (OCS) in the previous 12 months], and 47% required daily OCS. Median baseline peripheral blood eosinophil level was 590 cells·µL-1 Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%.Mepolizumab treatment reduced exacerbations requiring OCS compared to the previous year (annualised rate ratio 0.34 [95% CI 0.29-0.41], p<0.001) and hospitalisations (rate ratio 0.46 [95% CI 0.33-0.63], p<0.001). Treatment improved symptom control (median ACQ-5 reduced by 2.0 at 6 months), quality of life and lung function. Higher blood eosinophil levels (p=0.003) and later age of asthma onset (p=0.028) predicted a better ACQ-5 response to mepolizumab, whilst being male (p=0.031) or having body mass index ≥30 (p=0.043) predicted a lesser response. Super-responders (upper 25% of ACQ-5 responders, n=61, 24%) had a higher T2 disease burden and fewer comorbidities at baseline.Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22744
DOI: 10.1183/13993003.02420-2019
ORCID: 0000-0003-2489-227X
0000-0002-6695-6350
PubMed URL: 32139455
Type: Journal Article
Appears in Collections:Journal articles

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