Real-world mepolizumab treatment in eosinophilic granulomatosis with polyangiitis reduces disease burden in the United States

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-03-01 DOI:10.1016/j.anai.2024.11.004

Sameer K. Mathur MD, PhD , Jared Silver MD, PhD , Sean D. MacKnight MScPH , Ana Urosevic MA , Cristina Martinez MA , Kaixin Zhang MSc , François Laliberté MA , Arijita Deb PhD

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引用次数: 0

Abstract

Background

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, chronic inflammatory disease characterized by asthma and small/medium vessel vasculitis. Mepolizumab is approved for use in EGPA disease management alongside oral corticosteroids (OCS), but evidence of its real-world impact is limited.

Objective

To compare real-world treatment patterns and health outcomes, particularly OCS use, EGPA-related hospitalizations/relapses, and asthma exacerbations pre- and post-mepolizumab initiation in US patients with EGPA.

Methods

Patients with EGPA receiving more than or equal to 2 mepolizumab doses were identified using administrative claims data from Komodo Health's Comprehensive Dataset (between December 2016–March 2020). Outcomes assessed pre- and post-mepolizumab initiation included corticosteroid/other medication use, EGPA-related hospitalizations/relapses, and asthma exacerbations.

Results

Overall, 114 patients were identified; of these, 60 (53%) received mepolizumab 300 mg at index. Average daily OCS dose per dispensing was significantly lower post- vs pre-mepolizumab initiation (21.2 vs 26.8 mg/d, 21% relative reduction, P < .001); mean number of OCS bursts also decreased (0.9 vs 1.8, 50% relative reduction, P < .001). Patients experienced significantly lower rates of EGPA-related hospitalization (0.86 vs 1.55 per-person year [PPY], 49% relative reduction, P = .004) and EGPA relapse (3.18 vs 3.94 PPY, 19% relative reduction, P = .004) post- vs pre-initiation. Most patients (91%) had an asthma diagnosis at baseline; among these patients, asthma exacerbation rates were significantly lower post- vs pre-initiation (1.05 vs 1.84 PPY, 42% relative reduction, P = .004).

Conclusion

Mepolizumab was associated with significant steroid-sparing benefits and significantly reduced rates of EGPA-related hospitalizations, EGPA relapses, and asthma exacerbations in this real-world study of US patients with EGPA, confirming the benefits of mepolizumab treatment seen in clinical trials.

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在美国，嗜酸性粒细胞肉芽肿伴多血管炎患者使用甲泼尼珠单抗的实际治疗减少了疾病负担。

背景：嗜酸性粒细胞肉芽肿伴多血管炎（EGPA）是一种罕见的慢性炎症性疾病，以哮喘和中小血管炎为特征。美妥珠单抗已被批准与口服皮质类固醇（OCS）一起用于EGPA疾病的治疗，但有关其实际影响的证据却很有限：目的：比较美国 EGPA 患者开始使用美泊珠单抗前后的实际治疗模式和健康结果，尤其是 OCS 使用情况、EGPA 相关住院/复发以及哮喘加重情况：利用 Komodo Health 综合数据集（2016 年 12 月至 2020 年 3 月）中的行政报销数据，确定了接受≥2 次美泊珠单抗治疗的 EGPA 患者。对开始使用甲泼尼珠单抗前后的结果进行了评估，包括皮质类固醇/其他药物的使用、与EGPA相关的住院/复发以及哮喘加重：共确定了 114 名患者，其中 60 人（53%）在发病时接受了 300 毫克的美泊利珠单抗治疗。与开始使用美泊利珠单抗前相比，开始使用美泊利珠单抗后的患者平均每日OCS剂量明显降低（21.2 mg/day vs 26.8 mg/day，相对减少21%）：在这项针对美国 EGPA 患者的真实世界研究中，美泊利珠单抗具有明显的类固醇节省优势，并能显著降低 EGPA 相关住院率、EGPA 复发率和哮喘加重率，证实了临床试验中发现的美泊利珠单抗治疗优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.