Abstract Background and Objective In the J-Real-Mepo study, assessing the effectiveness of mepolizumab in real- world clinical setting in Japan, mepolizumab significantly reduced exacerbations, improved Asthma Control Test (ACT) scores, and reduced oral corticosteroid (OCS) dose regardless of patients’ characteristics. We further analyzed the efficacy of mepolizumab in words of achieving clinical remission (CR) and predictive factors for achieving CR. Methods CR definition included these criteria: (1) ACT score ≥ 23 during week 24-52, (2) no exacerbations during week 24-52, (3) no regular OCS use during week 24-52, and (4) %FEV1 ≥ 80% after week 4. “3-component” remission requiring criteria (1), (2), and (3), while “4-component” remission included all four criteria. To further explore the predictive factors for achieving CR, we also conducted classification and regression (CART) analysis. Results The 3-component remission rate achieved by one year treatment of mepolizumab was 31.1% (26/82), and the 4-component remission rate was 20.5% (15/63). Elevated levels of Gal10 significantly contributed to achieving ACT ≥ 23 remission component (OR 58.3, p = 0.0211). In the 3-component-ACT23 definition, asthma duration of less than 4036 days (≒11.0 years) was the most useful variable to predict CR achievement, with 66.7% of those cases achieving clinical remission. Among those with a disease duration of 11 years or more, serum Gal10 levels of 41.8 ng/mL or higher was the next useful variable contributing to CR achievement, reaching 61.5% attainment. Conclusion Mepolizumab treatment enabled 20% of severe asthmatic patients to achieve the most stringent definition CR in real-world settings in Japan. Gal10 may serve as a more reliable predictive biomarker for symptomatic improvement and CR achievement by mepolizumab treatment especially for patients with long disease history. Funding for this study was provided by GSK UMIN000045021. This abstract is funded by: GlaxoSmithKline Pharmaceutical
Kobayashi et al. (Fri,) studied this question.
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