Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study
IntroductionClinical remission as a multicomponent treatment goal in severe asthma is being explored in clinical practice. This post hoc analysis used data from the REDES study to assess the proportion of patients with severe eosinophilic asthma achieving our multicomponent definitions of clinical r...
| Auteurs principaux: | , , , , , , , , , , , , |
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| Format: | Article |
| Langue: | English |
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Frontiers Media S.A.
2023-04-01
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| Collection: | Frontiers in Immunology |
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| Accès en ligne: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1150162/full |
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| author | Ian Pavord Frances Gardiner Liam G. Heaney Christian Domingo Robert G. Price Alison Pullan John Oppenheimer Guy Brusselle Hiroyuki Nagase Geoffrey Chupp Emilio Pizzichini Emilio Pizzichini David Bañas-Conejero Peter Howarth |
| author_facet | Ian Pavord Frances Gardiner Liam G. Heaney Christian Domingo Robert G. Price Alison Pullan John Oppenheimer Guy Brusselle Hiroyuki Nagase Geoffrey Chupp Emilio Pizzichini Emilio Pizzichini David Bañas-Conejero Peter Howarth |
| author_sort | Ian Pavord |
| collection | DOAJ |
| description | IntroductionClinical remission as a multicomponent treatment goal in severe asthma is being explored in clinical practice. This post hoc analysis used data from the REDES study to assess the proportion of patients with severe eosinophilic asthma achieving our multicomponent definitions of clinical remission after 1 year of mepolizumab treatment.MethodsThe real-world, retrospective observational REDES study enrolled patients with severe eosinophilic asthma who were newly prescribed mepolizumab and with ≥12 months of medical records pre-enrolment. Multicomponent clinical remission was defined as: oral corticosteroid (OCS)-free; exacerbation-free; asthma control test (ACT) score ≥20; and with or without post-bronchodilator forced expiratory volume in 1 second ≥80%. Baseline characteristics were also assessed in those who did/did not achieve clinical remission.Results37% and 30% of patients with severe eosinophilic asthma met our proposed three- and four-component on-treatment clinical remission definitions; an increase from 2% and 3% at baseline. Most frequently achieved individual components of clinical remission were: OCS-free; ACT score ≥20. For patients fulfilling the multicomponent clinical remission definitions, at baseline we observed higher blood eosinophil counts, better ACT scores and lung function, lower maintenance OCS use, and a slightly lower rate of prior exacerbations versus those who did not.DiscussionClinical remission is a realistic target in clinical practice for a subset of patients with severe eosinophilic asthma receiving mepolizumab. Further studies are required to elucidate whether features linked to the underlying endotype can help predict treatment outcomes, increase rates of clinical remission, and potentially modify disease progression. |
| first_indexed | 2024-04-09T18:19:57Z |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-09T18:19:57Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-6a2297173f974771a34c24c5b9b4fa5c2023-04-12T11:02:29ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-04-011410.3389/fimmu.2023.11501621150162Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES studyIan Pavord0Frances Gardiner1Liam G. Heaney2Christian Domingo3Robert G. Price4Alison Pullan5John Oppenheimer6Guy Brusselle7Hiroyuki Nagase8Geoffrey Chupp9Emilio Pizzichini10Emilio Pizzichini11David Bañas-Conejero12Peter Howarth13Respiratory Medicine Unit and Oxford Respiratory National Institute for Health Research Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, United KingdomGlobal Medical, Global Specialty and Primary Care Therapy Area, GSK House, Brentford, United KingdomWellcome Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United KingdomServei de Pneumologia, Corporació Sanitària Parc Taulí, Sabadell, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainBiostatistics, GSK, Stevenage, United KingdomPlus-Project Partnership Ltd, Knutsford, United KingdomDepartment of Internal Medicine, Pulmonary and Allergy, UMDNJ-Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Respiratory Medicine, Ghent University Hospital, Ghent, BelgiumDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan0Yale Center for Asthma and Airways Disease (YCAAD), Yale School of Medicine, New Haven, CT, United StatesGlobal Medical, Global Specialty and Primary Care Therapy Area, GSK House, Brentford, United Kingdom1Department of Clinical Medicine, Federal University of Santa Catarina, Santa Catarina, Brazil2Specialty Care Medical Department, GSK, Madrid, SpainGlobal Medical, Global Specialty and Primary Care Therapy Area, GSK House, Brentford, United KingdomIntroductionClinical remission as a multicomponent treatment goal in severe asthma is being explored in clinical practice. This post hoc analysis used data from the REDES study to assess the proportion of patients with severe eosinophilic asthma achieving our multicomponent definitions of clinical remission after 1 year of mepolizumab treatment.MethodsThe real-world, retrospective observational REDES study enrolled patients with severe eosinophilic asthma who were newly prescribed mepolizumab and with ≥12 months of medical records pre-enrolment. Multicomponent clinical remission was defined as: oral corticosteroid (OCS)-free; exacerbation-free; asthma control test (ACT) score ≥20; and with or without post-bronchodilator forced expiratory volume in 1 second ≥80%. Baseline characteristics were also assessed in those who did/did not achieve clinical remission.Results37% and 30% of patients with severe eosinophilic asthma met our proposed three- and four-component on-treatment clinical remission definitions; an increase from 2% and 3% at baseline. Most frequently achieved individual components of clinical remission were: OCS-free; ACT score ≥20. For patients fulfilling the multicomponent clinical remission definitions, at baseline we observed higher blood eosinophil counts, better ACT scores and lung function, lower maintenance OCS use, and a slightly lower rate of prior exacerbations versus those who did not.DiscussionClinical remission is a realistic target in clinical practice for a subset of patients with severe eosinophilic asthma receiving mepolizumab. Further studies are required to elucidate whether features linked to the underlying endotype can help predict treatment outcomes, increase rates of clinical remission, and potentially modify disease progression.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1150162/fullsevere asthmaremissionclinical outcomesreal-worldeosinophil biologymepolizumab |
| spellingShingle | Ian Pavord Frances Gardiner Liam G. Heaney Christian Domingo Robert G. Price Alison Pullan John Oppenheimer Guy Brusselle Hiroyuki Nagase Geoffrey Chupp Emilio Pizzichini Emilio Pizzichini David Bañas-Conejero Peter Howarth Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study Frontiers in Immunology severe asthma remission clinical outcomes real-world eosinophil biology mepolizumab |
| title | Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study |
| title_full | Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study |
| title_fullStr | Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study |
| title_full_unstemmed | Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study |
| title_short | Remission outcomes in severe eosinophilic asthma with mepolizumab therapy: Analysis of the REDES study |
| title_sort | remission outcomes in severe eosinophilic asthma with mepolizumab therapy analysis of the redes study |
| topic | severe asthma remission clinical outcomes real-world eosinophil biology mepolizumab |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1150162/full |
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