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• W4387249964 abstract "SESSION TITLE: Asthma Biologic Update SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Severe eosinophilic asthma (SEA) and chronic obstructive pulmonary disease (COPD) are inflammatory diseases that cause airflow obstruction; despite having classically distinct etiologies these diseases may be difficult to distinguish, especially in patients who smoke and have fixed airflow limitation. Patients with SEA benefit from mepolizumab therapy; however, mepolizumab’s benefit in patients with SEA and a comorbid COPD diagnosis is unknown. Thus, we assessed real-world mepolizumab outcomes in patients with SEA and comorbid COPD or stratified by smoking status. METHODS: REALITI-A was a 2-year international, prospective study, enrolling adults with asthma newly prescribed (physician discretion) mepolizumab 100 mg subcutaneously (index). Data were collected 12 months pre- and 24 months post-index. Outcomes, stratified post hoc by physician-labelled COPD status (with/without) and smoking status (current/former smoker/never smoked [non-smoker]), at enrollment (based on medical records), included the rate of clinically significant exacerbations (CSEs; requiring systemic corticosteroids and/or hospitalization/emergency room visit) pre- and post-index and change from baseline (28 days pre-index) in daily maintenance oral corticosteroid (mOCS) dose at Weeks 101–104. RESULTS: Overall, 822 patients were enrolled. Versus pre-index, the rate of CSEs (rate ratio[95% CI]) reduced post-index regardless of COPD status (with: 0.32[0.24,0.43], n=82; without: 0.25[0.23,0.28], n=726). A similar reduction in the rate of CSEs was observed for former (0.27[0.24,0.32], n=290) and non-smokers (0.25[0.22,0.28], n=503), with a smaller reduction for current smokers (0.41[0.26,0.64], n=23). At Weeks 101–104 vs baseline, mOCS dose (mg/day; median[IQR]) reduced by 100%, irrespective of COPD status (with: 0.0[0.0,0.0] vs 10.0[5.0,15.0], n=32; without: 0.0[0.0,5.0] vs 10.0[5.0,13.1], n=282); mOCS was discontinued in 80% (8/10) of patients with COPD and in 55% (86/156) without COPD. At Weeks 101–104, mOCS dose reduced by 100% vs baseline for former (0.0[0.0,5.0] vs 10.0[5.0,15.0], n=111) and non-smokers (0.0[0.0,5.0] vs 10.0[5.0,12.5], n=201), with a smaller reduction for current smokers (5.0[2.5,5.5] vs 6.5[5.0,10.0], n=6). Overall, 58% (33/57) of former and 57% (62/108) of non-smokers discontinued mOCS by Weeks 101–104; no cases (0/3) of mOCS discontinuation were reported for current smokers. CONCLUSIONS: Real-world mepolizumab therapy reduced the rate of CSEs and mOCS use in patients with SEA, irrespective of comorbid COPD or patient smoking status. CLINICAL IMPLICATIONS: Mepolizumab provides clinical benefit in patients with SEA regardless of comorbid COPD and smoking status; however, patients who were current smokers had a smaller benefit than non-/former smokers, highlighting the importance of smoking cessation in maximizing responses to therapy. Funding: GSK(204710) DISCLOSURES: Speaker/Speaker's Bureau relationship with GSK Please note: Ongoing Added 03/31/2023 by Diego Bagnasco, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Novartis Please note: Ongoing Added 03/31/2023 by Diego Bagnasco, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Sanofi-Genzyme Please note: Ongoing Added 03/31/2023 by Diego Bagnasco, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with AstraZeneca Please note: Ongoing Added 03/31/2023 by Diego Bagnasco, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with GSK Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Chiesi Please note: November 2018 Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Advisory Committee Member relationship with Teva Please note: 2017 Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Advisory Committee Member relationship with Novartis Please note: November 2018 Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Sanofi Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Novartis Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Teva Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Chiesi Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Advisory Committee Member relationship with AstraZeneca Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria research grant esr relationship with AstraZeneca Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Grant/Research Speaker/Speaker's Bureau relationship with AstraZeneca Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Honoraria Advisory Committee Member relationship with GSK Please note: within 2 years Added 04/03/2023 by Rekha Chaudhuri, source=Web Response, value=Consulting fee Consultant relationship with Sanofi Genzyme Please note: 1/2022 to present Added 04/01/2023 by David Hill, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with Sanofi-Genzyme Please note: 1/2021 to present Added 04/01/2023 by David Hill, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Glaxo Smith Kline Please note: 1/2021 to present Added 04/01/2023 by David Hill, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Astra Zeneca Please note: 1/2021 to present Added 04/01/2023 by David Hill, source=Web Response, value=Honoraria Clinical Trial Support relationship with Glaxo Smith Kline Please note: 1/2022 to present Added 04/01/2023 by David Hill, source=Web Response, value=Grant/Research Support Clinical Trial Support relationship with Astra Zeneca Please note: 1/2022 to present Added 04/01/2023 by David Hill, source=Web Response, value=Grant/Research Support Employee relationship with GSK Please note: current Added 04/06/2023 by Peter Howarth, source=Web Response, value=Salary Employee relationship with GlaxoSmithKline Please note: Sep-2012 to present Added 04/03/2023 by Robert Price, source=Web Response, value=Salary Employee relationship with GlaxoSmithKline Please note: Sep-2012 to present Added 04/03/2023 by Robert Price, source=Web Response, value=Stocks/shares Fees for lectures relationship with GSK, AstraZeneca, Boehringer, Sanofi Aventis Please note: 2020-2023 Added 04/05/2023 by Tobias Welte, source=Web Response, value=Honoraria Advisory Committee Member relationship with GSK Please note: 2020-2022 by Tobias Welte, value=Honoraria Removed 04/05/2023 by Tobias Welte, source=Web Response" @default.
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• W4387249964 title "REAL-WORLD OUTCOMES WITH MEPOLIZUMAB IN PATIENTS WITH SEVERE EOSINOPHILIC ASTHMA ACCORDING TO SMOKING HISTORY AND COPD STATUS AT ENROLLMENT: REALITI-A POST HOC ANALYSIS" @default.
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