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. 2023 Jan 4:3:1052339.
doi: 10.3389/falgy.2022.1052339. eCollection 2022.

Real-World clinical outcomes of asthma patients switched from reslizumab to mepolizumab or benralizumab

Laura J Walsh  1 , Deborah Casey  1 , Punitha Vairamani  1 , Fiona Arnott  1 , Barry J Plant  1   2 , Desmond M Murphy  1   2
Affiliations

Real-World clinical outcomes of asthma patients switched from reslizumab to mepolizumab or benralizumab

Laura J Walsh et al. Front Allergy. .

Abstract

Introduction: Approximately 3%-10% of asthma patients will remain uncontrolled despite maximum, optimal conventional therapy. Treatment of severe refractory asthma often involves the use of targeted biological therapy. Randomised controlled trials have shown improvements in clinical parameters with these treatments but real-world data is lacking.

Methods: The clinical parameters, frequency of exacerbations, number of hospital admissions, asthma control questionnaire score (ACQ), forced expiratory volume in one second (FEV1) and maintenance oral corticosteroid (OCS) dose of twenty asthma patients switched from reslizumab to benralizumab or mepolizumab at 1 year prior and 6 months after switching were compared, with adjustments for time.

Results: The mean frequency of exacerbations (0.35 v 0.3) and the mean ACQ were essentially unchanged (1.6 v 1.5) following the switch. The number of hospital admissions was one in the 6 months post switch compared to one in 1-year pre switch. 25% of patients were on maintenance OCS before and after switching but one patient required an increased dose post switch resulting in an increase in the mean maintenance OCS dose (1.6 mg to 2.4 mg). The mean FEV1 was unchanged (80% v 77.9%) six months post switching. Regarding asthma control (n = 19), 47.4% were controlled pre and post switch (ACQ < 1.5), 36.8% remained uncontrolled despite switching, 10.5% improved control while 5.3% disimproved.

Conclusion: We present real-world clinical outcomes of asthma patients switched from reslizumab to either benralizumab or mepolizumab without a loss of clinical effectiveness in the majority.

Keywords: ACQ; asthma; biological therapy; exacerbation; real-word.

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Conflict of interest statement

Desmond Michael Murphy has received both speakers’ fees and fees for advisory boards from Astra Zeneca, GSK, Teva and Novartis. He has travelled to ERS 2022 as a guest of Astra Zeneca. The other authors report no conflicts of interest.

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