REALITI-A Study: Real-World Oral Corticosteroid-Sparing Effect of Mepolizumab in Severe Asthma.
J Allergy Clin Immunol Pract
; 10(10): 2646-2656, 2022 10.
Article
in English
| MEDLINE | ID: covidwho-2049376
ABSTRACT
BACKGROUND:
Patients with severe asthma may require maintenance oral corticosteroids (mOCS) for disease control as well as systemic corticosteroid (SCS) bursts for clinically significant exacerbations. However, mOCS and SCS use are associated with adverse effects, which increases patient disease burden.OBJECTIVE:
To assess the real-world corticosteroid-sparing effect of mepolizumab in patients with severe asthma.METHODS:
REALITI-A was a 24-month international, prospective, observational cohort study involving 84 centers across Europe, Canada, and the United States, with a 1-year pre-post mepolizumab treatment preplanned interim analysis. A total of 822 adults with a clinical diagnosis of asthma and a physician decision to initiate mepolizumab treatment (100 mg subcutaneously) were included. End points included daily mOCS dose at baseline (penultimate 28 days of pretreatment) and 1 year after treatment; percent reduction from baseline in mOCS dose; patients discontinuing mOCS 1 year after treatment; and the rate of clinically significant exacerbations (those requiring OCS for 3 days or more [or parenteral administration], emergency room visit, and/or hospital admission) before and after treatment.RESULTS:
A total of 319 patients received mOCS at baseline (median [interquartile range] 10.0 [5.0-15.0] mg/d). At 1 year after treatment, median mOCS dose was reduced by 75% (2.5 [0.0-5.0] mg/d); 64% of patients had a reduction in mOCS dose of 50% or greater compared with baseline and 43% discontinued mOCS. Clinically significant exacerbations decreased between pretreatment and posttreatment (rate ratio [95% confidence interval] 0.29 [0.26-0.32]; P < .001).CONCLUSION:
This 1-year analysis demonstrates that real-world mepolizumab treatment is clinically effective in patients with severe asthma, providing disease control while reducing the need for mOCS and SCS bursts.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Asthma
/
Anti-Asthmatic Agents
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Journal:
J Allergy Clin Immunol Pract
Year:
2022
Document Type:
Article
Affiliation country:
J.jaip.2022.05.042
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