Real-World Effectiveness of Mepolizumab in Patients with Allergic and Non-Allergic Asthma

Jared Silver; Andrea Steffens; Benjamin Chastek; Arijita Deb

doi:10.2147/JAA.S444693

Real-World Effectiveness of Mepolizumab in Patients with Allergic and Non-Allergic Asthma

J Asthma Allergy. 2024 Mar 23:17:261-271. doi: 10.2147/JAA.S444693. eCollection 2024.

Authors

Jared Silver¹, Andrea Steffens², Benjamin Chastek², Arijita Deb³

Affiliations

¹ Medical Affairs, GSK, Durham, NC, USA.
² Optum, Eden Prairie, MN, USA.
³ Value, Evidence and Outcomes, GSK, Upper Providence, PA, USA.

Abstract

Purpose: Real-world data on mepolizumab in patients with severe asthma and allergic and non-allergic phenotypes are limited. This study investigated the effectiveness of mepolizumab treatment in patients with severe asthma with allergic and non-allergic phenotypes.

Patients and methods: This retrospective cohort study (GSK ID: 214148) used administrative claims data from the Optum Research Database. Eligible patients were ≥6 years of age with asthma and had ≥2 mepolizumab claims post-index. Index date was the first mepolizumab claim/administration (January 2016-December 2018). Patients were divided into two cohorts: allergic and non-allergic asthma, based on diagnosis codes, medication use and lab test results. Outcomes included the rate of asthma-related exacerbations and oral corticosteroid (OCS) use during the 12 months before (baseline period) and 12 months after (follow-up period) mepolizumab initiation. Study ended in December 2019.

Results: Overall, 240 (44.6%) and 298 (55.4%) patients were included in the allergic and non-allergic asthma cohorts, respectively. Mean (standard deviation [SD]) counts of asthma-related exacerbations were significantly reduced from baseline to follow-up in both the allergic and non-allergic asthma cohorts (3.2 [2.5] to 2.1 [2.1], p < 0.001 and 2.5 [2.2] to 1.7 [1.9], p < 0.001, respectively). The mean number of OCS pharmacy claims was significantly decreased by 33.3% and 41.4% from baseline to follow-up in the allergic and non-allergic cohorts, respectively (p < 0.001); mean daily OCS dose significantly decreased by 30.6% and 45.4%, respectively (p < 0.001) as well as the mean number of OCS bursts, which decreased by 44.9% and 41.8%, respectively (p < 0.001). No significant differences were observed between cohorts in reductions in asthma exacerbations, counts of OCS pharmacy claims or OCS bursts (baseline to follow-up).

Conclusion: Mepolizumab significantly reduced asthma exacerbations and OCS use in patients with allergic and non-allergic asthma, suggesting that mepolizumab provides real-world benefit in severe asthma irrespective of whether a patient has an allergic phenotype.

Keywords: exacerbation; oral corticosteroid; phenotype; severe asthma.

Grants and funding

This study was funded by GSK (GSK Study ID: 214148). GSK was involved in the study design, data acquisition, data analysis and interpretation of the data, and manuscript preparation.