Impact of clinical remission on quality of life in severe eosinophilic asthma treated with mepolizumab.

Background: Biologics can induce clinical remission in severe asthma. However, the benefits of achieving remission from the patient's perspective remain unclear.

Objective: To assess the association between achieving clinical remission and health-related quality of life (HRQoL) in patients with severe eosinophilic asthma treated with mepolizumab.

Methods: In this nested, matched case-control study, data from the Australian Mepolizumab Registry (AMR) were used to compare the proportions of participants attaining Asthma Quality of Life Questionnaire (AQLQ[S]) scores of greater than or equal to 6, indicating minimal or no HRQoL impairment, between 42 participants who achieved clinical remission at 12 months and 64 propensity score-matched participants who did not. Assessed AQLQ(S) scores included overall and domain scores for symptoms, activity limitation, emotional function, and environmental stimuli. Clinical remission was assessed at 12 months, defined as Asthma Control Questionnaire-5 score less than 1.5, no exacerbations in the previous 12 months, and no oral corticosteroids use for asthma.

Results: A greater proportion of participants achieving clinical remission had AQLQ(S) scores of greater than or equal to 6 at 12 months compared with those who did not: overall scores (61.9% vs 26.6%, P = .001), symptom domain (59.5% vs 29.7%, P = .004), activity limitation domain (59.5% vs 28.1%, P = .003), emotional function domain (69.0% vs 31.2%, P < .001), and environmental stimuli domain (57.1% vs 34.4%, P = .035).

Conclusion: Achieving clinical remission at 12 months was associated with minimal or no impairment in HRQoL, although approximately 38% of participants in remission still experienced impaired HRQoL, highlighting residual unmet needs. Further research is needed to better understand the benefits of asthma remission from the patient's perspective.

Clinical trial registration: The AMR is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12618001497291). The AMR is a nationwide, multicenter, prospective, observational registry for the postmarketing surveillance of mepolizumab in severe eosinophilic asthma. The AMR is approved by the Human Research Ethics Committees in the study sites, and all participants provided written informed consent before enrollment.