THE SUSTAINED OCS-SPARING EFFECT OF MEPOLIZUMAB: RESULTS FROM THE REAL-WORLD REALITI-A STUDY AT 2 YEARS

Abstract

<h3>Introduction</h3> A main goal of asthma treatment is to reduce or eliminate oral corticosteroid (OCS) use due to their adverse effects. Clinical and real-world studies have reported mepolizumab reduces OCS use in patients with severe eosinophilic asthma (SEA); further evidence of the longer-term OCS-sparing effect of mepolizumab is needed. <h3>Methods</h3> REALITI-A was a 2-year international, prospective study, enrolling patients with asthma, newly prescribed mepolizumab 100 mg subcutaneously at physician's discretion. OCS-related outcomes were assessed at Weeks 53–56 and Weeks 101–104 in patients with baseline (28 days preceding mepolizumab initiation) maintenance OCS (mOCS) use and included: change from baseline in median mOCS dose, including stratification by mOCS dose categories, and proportion discontinuing mOCS. <h3>Results</h3> Of 822 patients treated, 320 (39%) had baseline mOCS use. Median (IQR) mOCS dose reduced from 10.0 (5.0, 14.7) mg/day at baseline (n=297) to 2.5 (0.0, 5.0) mg/day at Weeks 53–56 (n=218) and further to 0.0 (0.0, 5.0) mg/day at Weeks 101–104 (n=168), a 100% reduction. At baseline, 33% of patients (97/297) had a mean mOCS dose range of >10 mg/day, reducing to 10% (21/218) by Weeks 53–56 and 7% (12/168) by Weeks 101–104. In patients with baseline mOCS use, 43% (94/218) of patients discontinued mOCS use by Weeks 53–56, increasing to 57% (95/168) at Weeks 101–104. <h3>Conclusions</h3> During this 2-year real world study, mepolizumab demonstrated sustained and progressive OCS-sparing benefit in SEA, enabling a reduction in the burden associated with mOCS use for these patients.