Abstract Rationale Patients with chronic obstructive pulmonary disease (COPD) and raised blood eosinophil counts (BEC) can experience more frequent and severe exacerbations despite receiving standard of care with optimized inhaled treatment. This can lead to increased healthcare resource utilization (HCRU). Mepolizumab is a humanized anti-interleukin-5 monoclonal antibody recently approved as an add-on to triple therapy in patients with COPD and an eosinophilic phenotype (BEC ≥150 cells/µL). This study aimed to investigate HCRU in patients who initiated mepolizumab to treat COPD in the US, before regulatory approval for COPD in the US. Methods This real-world retrospective study used healthcare claims data from the Komodo Research database (01/2016─06/2024). The index date was defined as the first mepolizumab claim. Eligible patients had ≥2 mepolizumab claims from index to end of observation, were aged ≥40 years at index, had ≥12 months of continuous health insurance coverage or clinical activity pre-index, and had ≥2 COPD diagnosis claims during baseline (i.e., 12 months pre-index). Patients were excluded if they had ≥2 asthma diagnosis claims during baseline. Outcomes evaluated were COPD-related hospitalizations, emergency department (ED) visits, and outpatient (OP) visits during baseline and 12 months of follow-up (i.e., pre- and post-mepolizumab initiation periods, respectively). Results Of the 693 eligible patients, 343 (49.5%) were female, 510 (73.6%) were White, mean age was 64.6 years. Most patients were indexed in 2022 (158 22.8%) and were prescribed mepolizumab by a respiratory specialist (320 46.2%). In the 60 patients with a BEC assessment recorded during baseline, 42 (70%) had BEC ≥150 cells/µL and 27 (45%) BEC ≥300 cells/µL. Pre-mepolizumab, most patients experienced ≥1 moderate/severe exacerbation (490 70.7%), with a mean (standard deviation) number of 2.0 (2.1). In the 470 patients with ≥12 months of data coverage pre- and post-mepolizumab, the rate (per person-year PPY) of COPD-related hospitalizations pre- versus post-mepolizumab was 0.35 and 0.26, respectively, corresponding to a 25% (P = 0.038) rate reduction. There were 0.59 COPD-related ED visits PPY pre- versus 0.37 post-mepolizumab, corresponding to a 37% (P 0.001) rate reduction. Finally, the rate of COPD-related OP visits pre versus-post mepolizumab was 6.78 and 5.26 PPY, respectively, corresponding to a 22% (P 0.001 Figure) rate reduction. Conclusions In this real-world population of patients with COPD, initiation of mepolizumab was associated with significant reduction in COPD-related hospitalizations (i.e., ‘proxy of severe exacerbations’), ED visits, and OP visits. Patients had a high baseline exacerbation and HCRU burden that improved post-mepolizumab initiation. Funding GSK (300073). This abstract is funded by: GSK (300073)
Panettieri et al. (Fri,) studied this question.
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