Asthma Control in Patients with Severe Eosinophilic Asthma Treated with Reslizumab: Spanish Real-Life Data

Abstract

Luis A Pérez de Llano,1,* Borja G Cosío,2,* Ignacio Lobato Astiárraga,3 Gregorio Soto Campos,4 Miguel Ángel Tejedor Alonso,5 Nuria Marina Malanda,6 Alicia Padilla Galo,7 Isabel Urrutia Landa,8 Francisco J Michel de la Rosa,9 Ismael García-Moguel10 On behalf of the Reslizumab Real-Life Spanish Group1Pneumology Service, Hospital Lucus Augusti, Lugo, Spain; 2Pneumology Service, Hospital Universitario Son Espases-IdISBa-Ciberes, Palma de Mallorca, Spain; 3Pneumology Service, Complejo Asistencial de Ávila, Ávila, Spain; 4Pneumology and Allergy Unit, University Hospital of Jerez, Jerez de la Frontera, Cádiz, Spain; 5Allergy Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain; 6Pneumology Service, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain; 7Pneumology Service, Hospital Costa del Sol, Marbella, Málaga, Spain; 8Respiratory Department, Galdakao Hospital, Galdakao, Bizkaia, Spain; 9Pneumology Service, Hospital Universitario Donostia, San Sebastian, Spain; 10Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain*These authors contributed equally to this workCorrespondence: Borja G CosíoDepartment of Respiratory Medicine, Hospital Universitario Son ESPASES-IDISBA, Palma de Mallorca, SpainEmail [email protected]: Reslizumab is an anti-interleukin 5 monoclonal antibody that has demonstrated to reduce the risk of severe exacerbations and to improve symptoms, lung function, and quality of life in randomized controlled trials that included patients with severe eosinophilic uncontrolled asthma (SEUA) and a history of severe exacerbations.Objective: The aim of the present study was to evaluate the effectiveness of add-on reslizumab in a cohort of patients with SEUA under real-life conditions.Methods: This was a multi-centre, retrospective, real-life study that included subjects with SEUA treated with reslizumab in 44 asthma units throughout Spain. Eligible patients were those who had received at least one dose of reslizumab as part of normal clinical practice. The primary endpoint was complete asthma control at 52 weeks, defined as absence of severe exacerbations, ACT ≥ 20 and no maintenance oral corticosteroids (OCS). Demographic, clinical, and functional data were collected at baseline (T0), after four to six months (T1); after 12 months (T2) and beyond 12 months of therapy (T3).Results: Treatment with reslizumab achieved complete asthma control in 40% of the 208 included SEUA patients and led to a significant reduction in exacerbations (from 3.0; IQR: 2.0– 4.0 at V0 to 0.0; IQR: 0.0– 0.0 at V2), maintenance OCS use (from 54.8% (95% CI: 48.0– 61.6 at T0 to 18.5% (95% CI: 12.5– 24.5 at T2) and a meaningful improvement in symptoms in the entire treated population: ACT increased from 12.8 ± 4.5 at V0 to 20.0 ± 5.1 at V2 (p < 0.001). Most of the improvement achieved at 12 months was obtained at 4– 6 months. The retention (continuation) rate of reslizumab was 75% through 2 years (95CI%: 1.9– 2.1). Overall, reslizumab showed an adequate safety profile.Conclusion: Reslizumab is an effective therapy for SEUA with adequate safety profile in real-life conditions.Keywords: eosinophilic asthma, reslizumab, asthma control, monoclonal antibodies

Keywords

• eosinophilic asthma
• reslizumab
• asthma control
• monoclonal antibodies.