Mepolizumab benefits Japanese patients with severe eosinophilic asthma
medwireNews: Mepolizumab is effective for the treatment of severe eosinophilic asthma in Japanese patients, indicates a post-hoc analysis of the phase III MENSA trial.
Compared with placebo, intravenous (IV) mepolizumab reduced the annual rate of clinically significant exacerbations by 90% among 50 Japanese patients, and by 62% when delivered subcutaneously.
The patients, who were 12 years of age or older, received IV mepolizumab 75 mg, subcutaneous (SC) mepolizumab 100 mg, or placebo every 4 weeks for 32 weeks.
The annual rate of clinically significant exacerbations decreased compared with the year prior to treatment, from an average of 3.90 to 0.23 among the 17 receiving IV mepolizumab, from 5.10 to 0.88 among the 17 patients receiving SC mepolizumab, and from 4.80 to 2.32 for the 16 patients given placebo.
Lead author Terufumi Shimoda (Fukuoka National Hospital, Japan) and colleagues also note that emergency department or hospital admission for exacerbations was uncommon, with no events occurring in the IV mepolizumab group and three occurring in the SC mepolizumab group, relative to nine among patients given placebo. This gave an annual rate reduction of 73% for SC mepolizumab compared with placebo.
The researchers comment in Allergology Internationalthat these findings are consistent with those seen for the overall population.
Other comparable findings included a 40 L/minute increase in morning peak expiratory flow with IV mepolizumab and a 13 L/min increase with SC mepolizumab versus placebo, a respective 0.71 and 0.70 point decrease in mean Asthma Control Questionnaire-5 scores, and an 87% and 85% reduction in blood eosinophil counts.
Mepolizumab treatment also improved quality of life on the St George’s Respiratory Questionnaire beyond the minimal clinically important difference.
“Overall, these results suggest that mepolizumab is effective in reducing exacerbations in Japanese patients with severe eosinophilic asthma,” says the team, adding that the similarities with the overall trial population suggests “there is no clinically relevant inter-ethnic difference in the response to mepolizumab.”
The only discrepancy was a lack of improvement in pre-bronchodilator forced expiratory volume in 1 second with mepolizumab treatment, which the researchers attribute to the small sample size or differences in reversibility between the Japanese group and the overall population.
Mepolizumab’s safety profile was favorable, the researchers report, with the treatment-related adverse event rate similar across all three groups and serious events reported by four patients in the placebo group, four in the SC mepolizumab group, and one patient in IV mepolizumab group. Nasopharyngitis, which was the most common adverse event, was the only event to be reported by more patients taking mepolizumab versus placebo, but only by those receiving it by an IV route.
By Lucy Piper
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