Impact of demographics on mepolizumab effectiveness in severe asthma: One-year REALITI-A subanalysis (12/12 words).

Background: There is need for better understanding of the impact of demographic/clinical characteristics on outcomes with mepolizumab in patients with severe asthma.

Objective: Assess mepolizumab outcomes in severe asthma by demographic/clinical characteristics.

Methods: REALITI-A (GSK ID: 204710) was an international, prospective, observational study of adults with severe asthma (eosinophilic phenotype) initiating mepolizumab (100 mg subcutaneous). This 1-year post hoc subanalysis assessed outcomes stratified by sex, age of asthma onset, body mass index (BMI), smoking status, disease duration, and fractional exhaled nitric oxide (FeNO) in parts per billion. Outcomes included clinically significant asthma exacerbations (CSEs), maintenance oral corticosteroids (mOCS) usage, Asthma Control Questionnaire (ACQ)-5 scores, and pre-bronchodilator (pre-BD) forced expiratory volume in 1 second (FEV) between the pre-treatment/baseline and 12-month follow-up.

Results: Among 822 enrolled patients, 63% were female; of those with available data 79% were ≥18 years at asthma onset, 60% had never smoked, and 37% were former smokers. Across all subgroups following mepolizumab treatment, CSEs were significantly reduced by 53-79%; except the current smoker subgroup mOCS doses were numerically reduced by 50-100% and least squares (LS) mean ACQ-5 scores significantly improved by -1.02 to -1.57; LS mean pre-BD FEV significantly improved by 3.1-8.4% (except current smoker, BMI≥30 and FeNO <25 and 25-<50 subgroups). There were trends towards greater reduction in CSE rates with older age of onset, BMI <25 kg/m and non-/former smoker subgroups.

Conclusion: Mepolizumab improved outcomes in patients with severe asthma over a varied demographic spectrum in this large real-world study.