MATSUMOTO Etsuko
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title Real-world effectiveness of mepolizumab in Japanese asthma patients with diverse backgrounds: Improvements in rhinosinusitis imaging (J-Real-Mepo).
Journal Formal name：Allergology international : official journal of the Japanese Society of Allergology
Abbreviation：Allergol Int
ISSN code：14401592/13238930
Domestic / ForeginDomestic
Volume, Issue, Page 22,pp.S1323-8930(24)00162-X
Author and coauthor Nagase Hiroyuki†, Kobayashi Konomi, Toma-Hirano Makiko, Suzukawa Maho, Harada Norihiro, Masaki Katsunori, Miyata Yoshito, Tsuji Mayoko, Terada-Hirashima Junko, Komatsuzaki Keiko, Sasano Hitoshi, Mizumura Kenji, Kagoya Ryoji, Shimizu Yuya, Yoshihara Shintaro, Kihara Norio, Miyazaki Yasunari, Koya Toshiyuki, Sugihara Naruhiko, Ishikawa Nobuhisa, Hojo Masayuki, Tagaya Etsuko, Tanaka Akihiko, Fukunaga Koichi, Gon Yasuhiro,
Publication date 2025/01
Summary BACKGROUND:Although randomized controlled trials (RCT) have demonstrated the efficacy of mepolizumab for asthma, they have excluded certain patient subgroups. To bridge the gap between RCT and real-world practice, the effectiveness of mepolizumab in a diverse population, including those potentially excluded from RCT, was assessed. Its effects on imaging findings and symptoms of chronic rhinosinusitis (CRS) with asthma were also assessed.METHODS:This retrospective observational study of patients in Japan (J-Real-Mepo: UMIN000045021) evaluated multiple endpoints and analyzed the relationship between clinical background and treatment outcomes.RESULTS:Mepolizumab significantly reduced exacerbations, improved Asthma Control Test (ACT) scores, and forced expiratory volume in 1 s, and reduced oral corticosteroid (OCS) dose, regardless of patient characteristics, including age, body mass index, smoking history, and comorbidities. Regarding RCT exclusion criteria, 29.4 % of patients had no history of exacerbations. Although 25.4 % of these patients required continuous OCS, the OCS dose was reduced similar to those with a history of exacerbations. Disease control and mepolizumab effectiveness in patients with a smoking history ≥10 pack-years was similar to that of never-smokers. Patients with eosinophil counts <150/μL had lower ACT scores and higher OCS use compared with patients with eosinophilia and comparable effectiveness regarding exacerbation and OCS reduction. Significant improvements in Lund-Mackay scores and CRS symptoms were observed.CONCLUSIONS:Mepolizumab effectiveness was demonstrated in a broad range of patients including those with RCT exclusion criteria, who had significant disease or OCS burden. These findings may explain the consistent results between RCT and real-world studies of mepolizumab.
DOI 10.1016/j.alit.2024.12.005
PMID 39848869