Introduction: Asthma is one of the most common chronic diseases and affects around 334 million people worldwide. The estimated prevalence of severe asthma is 3–10% of the asthmatic population. Mepolizumab has demonstrated efficacy in reducing exacerbations, oral corticosteroid use, and improving quality of life, asthma control, and lung function in patients with severe eosinophilic asthma (SEA). Our study aimed to check the response to mepolizumab in a series of severe asthma patients regarding exacerbations, oral corticosteroid use, asthma control, quality of life, and lung function and to compare the response between patients with and without nasal polyps. Method: This is a retrospective, multicenter study of RE-ASGRAMUR (Register of Severe Asthma of the Region of Murcia) performed in eight hospitals of the Region of Murcia (Spain) under routine clinical practice conditions. We included patients diagnosed with SEA who completed at least 1 year of treatment with mepolizumab. We analyzed clinical characteristics, drug tolerance, and effectiveness: exacerbations, ACT, miniAQLQ, forced expiratory volume in 1 s (FEV1), and use of oral corticosteroids. We also compared the results between patients with and without nasal polyps. Results: The median of exacerbations before treatment was 3 and decreased to 0 after treatment (mean decrease of 77.4%). The median diary oral prednisone intake was 15 mg before treatment and 5 mg after treatment (mean 56% reduction). We have obtained a significant improvement in other variables: ED visits and hospitalizations, asthma control (ACT), quality of life (miniAQLQ), and lung function (FEV1). Thirty-four out of 70 patients (48.57%) fulfilled the criteria of super-responder, and 17 out of 70 (24.29%) had a complete response. More patients in the group with nasal polyps fulfilled the criteria of super-responder and complete response to mepolizumab. Conclusions: Mepolizumab is a safe and effective treatment for SEA patients, improving exacerbations, oral corticosteroid intake, asthma control, quality of life, and lung function. In patients with associated nasal polyposis, there is a statistically significant higher proportion of super-responders and complete responders.

1.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators
Abajobir
AA
,
Abate
KH
,
Abbafati
C
,
Abbas
KM
,
Abd-Allah
F
.
Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
.
Lancet
.
2017
;
390
(
10100
):
1211
59
.
2.
Chung
KF
,
Wenzel
SE
,
Brozek
JL
,
Bush
A
,
Castro
M
,
Sterk
PJ
et al
.
International ERS/ATS guidelines on definition, evaluation, and treatment of severe asthma
.
Eur Respir J
.
2014
;
43
(
2
):
343
73
.
3.
Hekking
PP
,
Wener
RR
,
Amelink
M
,
Zwinderman
AH
,
Bouvy
ML
,
Bel
EH
.
The prevalence of severe refractory asthma
.
J Allergy Clin Immunol
.
2015
;
135
(
4
):
896
902
.
4.
Pavord
ID
,
Korn
S
,
Howarth
P
,
Bleecker
ER
,
Buhl
R
,
Keene
ON
et al
.
Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial
.
Lancet
.
2012
;
380
(
9842
):
651
9
.
5.
Ortega
HG
,
Liu
MC
,
Pavord
ID
,
Brusselle
GG
,
FitzGerald
JM
,
Chetta
A
et al
.
Mepolizumab treatment in patients with severe eosinophilic asthma
.
N Engl J Med
.
2014
;
371
(
13
):
1198
207
.
6.
Bel
EH
,
Wenzel
SE
,
Thompson
PJ
,
Prazma
CM
,
Keene
ON
,
Yancey
SW
et al
.
Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma
.
N Engl J Med
.
2014
;
371
(
13
):
1189
97
.
7.
Chupp
GL
,
Bradford
ES
,
Albers
FC
,
Bratton
DJ
,
Wang-Jairaj
J
,
Nelsen
LM
et al
.
Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial
.
Lancet Respir Med
.
2017
;
5
:
390
400
.
8.
Domingo Ribas
C
,
Carrillo Díaz
T
,
Blanco Aparicio
M
,
Martínez Moragón
E
,
Banas Conejero
D
,
Sánchez Herrero
MG
et al
.
REal worlD effectiveness and safety of mepolizumab in a multicentric Spanish cohort of asthma patients stratified by eosinophils: the REDES Study
.
Drugs
.
2021
;
81
(
15
):
1763
74
.
9.
Miralles-López
JC
,
Andújar-Espinosa
R
,
Bravo-Gutiérrez
FJ
,
Castilla-Martínez
M
,
Flores-Martín
I
,
Alemany-Francés
ML
et al
.
Analysis of response of severe eosinophilic asthmatic patients to benralizumab
.
Allergol Immunopathol
.
2022
;
50
(
6
):
163
8
.
10.
Alvarez-Gutierrez
FJ
,
Blanco-Aparicio
M
,
Plaza
V
,
Cisneros
C
,
Garcia-Rivero
JL
,
Padilla
A
et al
.
Documento de consenso de asma grave en adultos. Actualizacion 2020
.
Open Respir Arch
.
2020
;
2
(
3
):
158
74
.
11.
Canonica
GW
,
Blasi
F
,
Carpagnano
GE
,
Guida
G
,
Heffler
E
,
Paggiaro
P
et al
.
Severe asthma network Italy definition of clinical remission in severe asthma: a delphi consensus
.
J Allergy Clin Immunol Pract
.
2023
S2213-2198(23)00816-4
. Ahead of print.
12.
Loli-Ausejo
D
,
Perdomo
G
,
Mascaró
B
,
Martínez-Olondris
P
,
Sánchez-Fernández
MC
,
Mullol
J
et al
.
Mepolizumab for treatment of severe eosinophilic asthma: a 5-year real-world experience
.
J Investig Allergol Clin Immunol
.
2023
;
33
(
3
):
209
10
.
13.
Kavanagh
JE
,
d’Ancona
G
,
Elstad
M
,
Green
L
,
Fernandes
M
,
Thomson
L
et al
.
Real-world effectiveness and the characteristics of a “Super-Responder” to mepolizumab in severe eosinophilic asthma
.
Chest
.
2020
;
158
(
2
):
491
500
.
14.
Rodríguez-García
C
,
Blanco-Aparicio
M
,
Nieto-Fontarigo
JJ
,
Blanco-Cid
N
,
Gonzalez-Fernandez
C
,
Mosteiro-Añon
M
et al
.
Efficacy of mepolizumab in usual clinical practice and characteristics of responders
.
Respir Med
.
2021
;
187
:
106595
.
15.
Cakmak
ME
,
Öztop
N
,
Yeğit
OO
,
Özdedeoğlu
Ö
.
Evaluation of the clinical features and laboratory data of patients with severe eosinophilic asthma classified as super-responders, partial responders, or nonresponders to mepolizumab treatment: a real-life study
.
Int Arch Allergy Immunol
.
2023
;
184
:
736
43
.
16.
Arismendi
E
,
Cisneros
C
,
Blanco-Aparicio
M
,
Martínez-Moragón
E
,
Quirce
S
,
Bañas Conejero
D
et al
.
REDES Study: mepolizumab is effective in patients with severe asthma and comorbid nasal polyps
.
J Investig Allergol Clin Immunol
.
2023
;
33
(
6
):
0
.
17.
Kritikos
V
,
Harvey
ES
,
Stevens
S
,
Katelaris
CH
,
Langton
D
,
Rimmer
J
et al
.
Comorbidities modify the phenotype but not the treatment effectiveness to mepolizumab in severe eosinophilic asthma
.
J Allergy Clin Immunol Pract
.
2023
;
11
(
3
):
885
95.e13
.
18.
Pilette
C
,
Canonica
GW
,
Chaudhuri
R
,
Chupp
G
,
Lee
FE
,
Lee
JK
et al
.
REALITI-A Study: real-world oral corticosteroid-sparing effect of mepolizumab in severe asthma
.
J Allergy Clin Immunol Pract
.
2022
;
10
:
2646
56
.
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