P210 The impact of introducing anti-IL-5/5R biologic therapies on weight and BMI in prednisolone-dependent patients with severe asthma

Abstract

<h3>Introduction</h3> Weight gain is a well-recognised adverse effect of oral corticosteroid (OCS) therapy. Obesity is a frequently seen co-morbidity in asthma and has been shown to inadvertently affect patient reported outcomes¹. Biologic therapies for severe eosinophilic asthma (SEA) reduce exposure to OCS but there is no long-term data on whether these therapies lead to a significant change in weight. <h3>Method</h3> We retrospectively identified patients with SEA who had received either mepolizumab or benralizumab for a minimum of 3 years and who were on maintenance (m)OCS at baseline. Body mass index (BMI), weight and mOCS dose at the start of treatment and at 3-year review were recorded. A clinically significant change in weight was defined as a change of ±5% body weight. <h3>Results</h3> Sixty-two patients (62% female, mean [SD] age 54.3 [12.9]) were identified (n=40, mepolizumab; n=22, benralizumab). The mean follow-up duration was 50.5 months. At baseline, mean BMI was 30.7 kg/m² (6.1) and the median (IQR) daily mOCS dose 10 mg (5–15). At follow up, 85.5% of patients were no longer taking mOCS; of those who continued, 2 did so for asthma control and 7 for adrenal insufficiency. The median OCS dose reduced to 0 mg (0–0). The mean change in body weight across the cohort was -1.3% (10.2) and -3.1% (9.5) in the obese subgroup. Twenty patients (32.3%) achieved significant weight loss (-11.9% [6.3]), 15/62 (24.2%) gained significant weight (+11.8% [6.0] and 27/62 (43.5%) had no significant change (-0.73% [2.93]). Baseline BMI, age, gender, mOCS dose or biologic agent did not predict which patients gained or lost weight. <h3>Conclusion</h3> Treatment with anti-IL-5/5R biologics did not lead to a significant change in weight in patients with SEA over a 3 year period. Despite significant reductions in OCS exposure, only a third of patients had a clinically meaningful reduction in weight, with almost a quarter of patients increasing their weight significantly. Obese patients should be offered additional support to lose weight. <h3>References</h3> Peters U, Dixon AE, Forno E. Obesity and asthma. <i>J Allergy Clin Immunol</i>. 2018 Apr;<b>141</b>(4):1169–1179.