| Autor: |
Vicky Kritikos, Erin S. Harvey, Sean Stevens, Constance H. Katelaris, David Langton, Janet Rimmer, Claude S. Farah, Andrew Gillman, Mark Hew, Naghmeh Radhakrishna, Dennis Thomas, Peter G. Gibson, Melissa Baraket, Philip Bardin, Jeffrey J. Bowden, Simon Bowler, Jimmy Chien, Li Ping Chung, Christopher Grainge, Nicholas Harkness, Zinta Harrington, Christine Jenkins, Gregory P. Katsoulotos, Vanessa M. McDonald, Joy Lee, Matthew Peters, Helen K. Reddel, Paul N. Reynolds, Pathmanathan Sivakumaran, John W. Upham, Peter A.B. Wark |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
The Journal of Allergy and Clinical Immunology: In Practice. 11:885-895.e13 |
| ISSN: |
2213-2198 |
| Popis: |
Comorbidities in severe asthma are common and contribute to disease burden. The severe asthma phenotype and treatment response can be impacted by comorbid conditions. Real-world data on the use of mepolizumab in severe eosinophilic asthma (SEA) in the presence of comorbidities is needed to inform clinical practice.To investigate the impact of comorbid conditions on baseline phenotype in patients with SEA and assess the mepolizumab treatment effect by comorbidity status in SEA.Patients enrolled in the Australian Mepolizumab Registry (n=309) were classified into subgroups defined by the presence or absence of comorbidities, including nasal polyps, aspirin exacerbated airway disease, asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO), fungal sensitisation and obesity. Patient baseline characteristics were compared, and the impacts of comorbidity on phenotype, identified by differences in patient age and/or baseline biomarker levels and/or asthma severity, were assessed. The mepolizumab treatment effects on clinical and biological outcomes at 12 months were assessed.Across comorbidity subgroups, mepolizumab reduced the rate of clinically significant exacerbations (range 47-77%), maintenance oral corticosteroid use (dose reduction 4.2-13.3 mg/day), and improved symptom control (Asthma Control Questionnaire-5 score 1.9-2.4 point reduction) and lung function (mean 3.4-9.3 post-bronchodilator percent predicted forced expiratory volume in 1s). Peripheral blood eosinophils were reduced (mean 480-780 cells/μL). Comorbidities (nasal polyps, obesity, ACO and fungal sensitisation) modified the baseline phenotype.Mepolizumab treatment is associated with comparable clinical improvements in in patients with SEA and comorbidities. Mepolizumab effectively minimizes the disease impact and corticosteroid burden in patients with SEA. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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