Biological Anti-IL-5/IL-5R Therapeutics for Chronic Obstructive Pulmonary Disease (COPD) with Specific Treatable Traits: A Real-World Retrospective Analysis

Abstract

Forest Day de Larrañaga,1,2 Alexandre Joubert,3 Isabelle Drouin,3 Isabelle Ouellet,3 Pei Zhi Li,1 Bryan A Ross,1– 3 Carolyn J Baglole,1,2 Jean Bourbeau1– 3 1Research Institute of McGill University Health Centre, Montreal, Quebec, Canada; 2Department of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada; 3COPD Clinic, McGill University Health Centre, Montreal, Quebec, CanadaCorrespondence: Jean Bourbeau, Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, 5252 De Maisonneuve, room 3D.62, Montreal, QC, H4A 3S5, Canada, Email [email protected]: We describe the use of anti-IL-5 monoclonal antibodies from a COPD clinic, a source other than traditional clinical trials. The objectives were to characterize the patient subgroup prescribed anti-IL-5 monoclonal antibodies and to report potential benefits.Methods: This is a retrospective case series study of 17 patients treated in a COPD subspecialty clinic. All patients had a diagnosis of COPD (post-bronchodilator FEV1/FVC < 0.7) and had been prescribed an anti-IL-5 biologic for at least 8 months. Acute exacerbations of COPD (AECOPDs) were collected as reported in electronic medical records.Results: All patients (17) enrolled were treated with biologics for ≥ 8 months, and 13 (76%) for ≥ 1 year. Patients were characterized by severe disease traits, FEV1 < 50% predicted, recurrent exacerbations (3.5 moderate-to-severe AECOPDs in the year before treatment), high peripheral blood eosinophil counts (≥ 250 cells/μL in the previous year), all on inhaled triple therapy, and only 1 patient with a diagnosis of asthma prior to smoking. There was a statistically significant decrease in the exacerbation rate compared with baseline after 8 and 12 months of anti-IL-5 treatment, respectively, yielding the equivalent of a 2– 3x reduction in exacerbation rate. Absolute FEV1 decreased, and the decline in FEV1 % of predicted reached statistical significance (p< 0.05); CAT score improved (p< 0.05).Discussion: This real-world evidence data aligns with existing studies suggesting the potential benefit of anti-IL-5 treatment for specific patients with COPD and therefore advocates for further investigation of RCTs on the use of anti-IL-5 biologics for well-characterized patients with COPD.Keywords: COPD, biologics, anti-IL5 therapy, blood eosinophil count, RWE, RWD

Keywords

• copd
• biologics
• anti-il5 therapy
• blood eosinophil count
• rwe