Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/27094
Title: Mepolizumab and Oral Corticosteroid Stewardship: Data from the Australian Mepolizumab Registry.
Austin Authors: Thomas, Dennis;Harvey, Erin S;McDonald, Vanessa M;Stevens, Sean ;Upham, John W;Katelaris, Constance H;Kritikos, Vicky;Gillman, Andrew;Harrington, John;Hew, Mark;Bardin, Philip;Peters, Matthew;Reynolds, Paul N;Langton, David;Baraket, Melissa;Bowden, Jeffrey J;Bowler, Simon;Chien, Jimmy;Chung, Li Ping;Farah, Claude S;Grainge, Christopher;Jenkins, Christine;Katsoulotos, Gregory P;Lee, Joy ;Radhakrishna, Naghmeh;Reddel, Helen K;Rimmer, Janet;Sivakumaran, Pathmanathan;Wark, Peter A B;Gibson, Peter G
Affiliation: Department of Thoracic Medicine, St Vincent's Clinic, Darlinghurst, Australia
St George and Sutherland Clinical School, University of New South Wales, Sydney, Australia
Woolcock Institute of Medical Research, University of Sydney, Glebe, Australia
Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Newcastle, Australia
Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Australia
Allergy, Asthma and Clinical Immunology Clinic, Alfred Health, Melbourne, Australia
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
Lung Sleep Allergy & Immunology, Monash University and Medical Centre and Hudson Institute, Clayton, Melbourne, Australia
Department of Thoracic Medicine, Concord Hospital, Concord, Australia
Lung Research Unit, Department of Thoracic Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia
Respiratory and Sleep Services, Flinders Medical Centre and Flinders University, Bedford Park, Australia
Department of Respiratory Medicine, Mater Hospital, Brisbane, Australia
Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Australia
Respiratory and Sleep Medicine
Respiratory Department, St Vincent's Hospital, Melbourne, Australia
Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Australia
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia.
Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, Australia
Faculty of Medicine, the University of Queensland, Brisbane, Australia
School of Medicine, Western Sydney University, Campbelltown, Australia
Immunology and Allergy Unit, Campbelltown Hospital, Campbelltown, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
Department of Thoracic Medicine, Frankston Hospital, Frankston, Australia
South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
Department of Respiratory Medicine, Ingham Institute for Applied Medical Research, Sydney, Australia
Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, Australia
School of Medicine, the University of Sydney, Sydney, Australia
Concord Clinical School, University of Sydney, Concord, Australia
St George Specialist Centre, Kogarah, Australia
Issue Date: Jul-2021
Date: 2021-02-03
Publication information: The Journal of Allergy and Clinical Immunology. In Practice 2021; 9(7): 2715-2724.e5
Abstract: Oral corticosteroids (OCS) carry serious health risks. Innovative treatment options are required to reduce excessive exposure and promote OCS stewardship. This study evaluated the trajectories of OCS exposure (prednisolone-equivalent) in patients with severe eosinophilic asthma before and after starting mepolizumab and the predictors of becoming OCS free after 6 months of mepolizumab therapy. This real-world observational study included 309 patients from the Australian Mepolizumab Registry who were followed up for 1 year (n = 225). Patients had a median age of 60 (interquartile range: 50, 68) years, and 58% were female. At baseline, 48% used maintenance OCS, 96% had ≥1 OCS burst, and 68% had received ≥1 g of OCS in the previous year. After commencing mepolizumab, only 55% of those initially on maintenance OCS remained on this treatment by 12 months. Maintenance OCS dose reduced from median 10 (5.0, 12.5) mg/day at baseline to 2 (0, 7.0) mg/day at 12 months (P < .001). Likewise, proportions of patients receiving OCS bursts in the previous year reduced from 96% at baseline to 50% at 12 months (P < .001). Overall, 137 (48%) patients required OCS (maintenance/burst) after 6 months' mepolizumab therapy. Becoming OCS free was predicted by a lower body mass index (odds ratio: 0.925; 95% confidence interval: 0.872-0.981), late-onset asthma (1.027; 1.006-1.048), a lower Asthma Control Test score (1.111; 0.011-1.220), and not receiving maintenance OCS therapy at baseline (0.095; 0.040-0.227). Mepolizumab led to a significant and sustained reduction in OCS dependence in patients with severe eosinophilic asthma. This study supports the OCS-sparing effect of mepolizumab and highlights the pivotal role of mepolizumab in OCS stewardship initiatives.
URI: https://ahro.austin.org.au/austinjspui/handle/1/27094
DOI: 10.1016/j.jaip.2021.01.028
Journal: The Journal of Allergy and Clinical Immunology. In Practice
PubMed URL: 33545399
Type: Journal Article
Subjects: Mepolizumab
OCS stewardship
Observational study
Oral corticosteroid
Severe eosinophilic asthma
Appears in Collections:Journal articles

Show full item record

Page view(s)

30
checked on May 30, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.