Characterisation of exacerbations of severe eosinophilic asthma (SEA) on mepolizumab compared to placebo

Rahul Shrimanker, Beverley Hargaden, Peter Bradding, AJ Wardlaw, CE Brightling, Ruth Green, Mona Bafadhel, ID Pavord, Pranab Haldar, L Heaney
2017 Airway Pharmacology and Treatment   unpublished
2 University of Leicester -Leicester (United Kingdom), 3 Queen's University Belfast -Belfast (United Kingdom) Mepolizumab reduces exacerbations of SEA. The nature of exacerbations on mepolizumab is unclear. We have tested the hypothesis that these exacerbations differ in inflammatory profile, symptoms, FEV1 and response to oral corticosteroids (OCS). Methods A RCT of mepolizumab in SEA was conducted (Haldar, NEJM 2009;360). Subjects were reviewed at exacerbation, prior to starting treatment or
more » ... rting treatment or as soon as possible after. Spirometry, Asthma Control Questionnaire (ACQ5), visual analogue scale (VAS) (cough, breathlessness, wheeze) and induced sputum counts were measured. Results 177 exacerbations were assessed-101 prior to treatment (pre-treatment) and 76 after starting OCS (treated) with no difference in the duration of OCS in the treated groups. Pre-treatment increase from baseline VAS was 39 vs 20mm (p<0.01), change in ACQ5, 1.0 vs 0.59 (p=0.09) and geometric mean sputum eosinophils 5.9 vs 2.3%, (p=0.03) in placebo vs mepolizumab arms respectively.
doi:10.1183/1393003.congress-2017.pa3971 fatcat:6kxqxj3gdfdsnb3uh7em77b2fi