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2016 ; 71
(9
): 1335-44
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Treatment response with mepolizumab in severe eosinophilic asthma patients with
previous omalizumab treatment
#MMPMID27087007
Magnan A
; Bourdin A
; Prazma CM
; Albers FC
; Price RG
; Yancey SW
; Ortega H
Allergy
2016[Sep]; 71
(9
): 1335-44
PMID27087007
show ga
BACKGROUND: We performed post hoc analyses to evaluate the effect of humanized
monoclonal antibody mepolizumab in patients with severe eosinophilic asthma
previously treated with omalizumab. METHODS: Data were collected from two
randomized double-blind, placebo-controlled studies: MENSA (NCT01691521: 32-week
treatment phase) and SIRIUS (NCT01691508: 24-week treatment phase). Active
treatment was 75 mg intravenous mepolizumab (MENSA) or 100 mg subcutaneous
mepolizumab (MENSA, SIRIUS). Patients had evidence of eosinophilic inflammation
?150 cells/?l (at screening) or ?300 cells/?l (during the previous year). Primary
outcomes were the rate of exacerbations (MENSA) and the percentage reduction in
oral corticosteroid (OCS) dose (SIRIUS). Other outcomes included lung function
(forced expiratory volume in 1 s and morning peak expiratory flow), Asthma
Control Questionnaire (ACQ-5), St George's Respiratory Questionnaire (SGRQ)
scores, and safety. RESULTS: Overall, 576 patients were included from MENSA and
135 from SIRIUS, with 13% and 33% previously receiving omalizumab, respectively.
In MENSA, mepolizumab reduced the rate of exacerbations by 57% (prior omalizumab)
and 47% (no prior omalizumab) vs placebo. In SIRIUS, reductions in OCS use were
comparable regardless of prior omalizumab use. Despite reducing chronic OCS use,
mepolizumab also resulted in similar reductions in exacerbation rate relative to
placebo in both subgroups. Asthma control and quality of life improved with
mepolizumab vs placebo in both studies independent of prior omalizumab use, as
shown by ACQ-5 and SGRQ scores. Adverse events were also comparable irrespective
of prior omalizumab use. CONCLUSIONS: These post hoc analyses indicate that
patients with severe eosinophilic asthma respond positively to mepolizumab
regardless of prior use of omalizumab.
|Adolescent
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Anti-Asthmatic Agents/*therapeutic use
[MESH]
|Antibodies, Monoclonal, Humanized/*therapeutic use
[MESH]