Real-world effectiveness of mepolizumab in patients with severe asthma and associated comorbidities

Ann Allergy Asthma Immunol. 2021 Sep;127(3):354-362.e2. doi: 10.1016/j.anai.2021.05.021. Epub 2021 May 24.

Abstract

Background: Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management.

Objective: To describe the real-world effectiveness of mepolizumab in patients with severe asthma stratified by common overlapping comorbidities.

Methods: This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had more than or equal to 1 claim (excluding claims for diagnostic tests) with a diagnosis code for more than or equal to 1 of 7 comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month preindex baseline period; these were used to stratify patients into 7 nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related health care resource utilization during the 12-month baseline and follow-up periods. Each patient acted as their own control.

Results: Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all 7 comorbidity subgroups, there were significant (P < .05) reductions of 38% to 55% and 57% to 83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up vs baseline period, except for exacerbations requiring hospitalization in the nasal polyp subgroup, owing to the small subgroup sample size. During the follow-up vs baseline periods, mean number of oral corticosteroids claims was significantly (P < .001) reduced by 29% to 38%; 39% to 47% of patients achieved greater than or equal to 50% oral corticosteroids dose reduction. Significant reductions in exacerbation-related health care resource utilization were also observed.

Conclusion: Mepolizumab treatment provided real-world clinical benefits in patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Anxiety / drug therapy
  • Anxiety / epidemiology
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • Chronic Disease
  • Comorbidity
  • Depression / drug therapy
  • Depression / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps / drug therapy
  • Nasal Polyps / epidemiology
  • Obesity / drug therapy
  • Obesity / epidemiology
  • Patient Acceptance of Health Care
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Retrospective Studies
  • Severity of Illness Index
  • Sinusitis / drug therapy
  • Sinusitis / epidemiology
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • mepolizumab