Abstract Rationale Anti-interleukin (IL)-5 biologics are effective in the treatment of severe eosinophilic asthma, improving asthma control and reducing steroid exposure. The effect of biologics on weight and body composition one year post biologic initiation shows conflicting results. Therefore, we aimed to examine the long-term effect of IL-5/5Ra therapy on weight and body mass index (BMI). Methods We performed a retrospective review of patients with severe asthma aged ≥18 years receiving mepolizumab (IL-5) or benralizumab (IL-5Ra) ≥1 year at our severe asthma clinic from 2019 to 2024. Patient’s height, weight, BMI and steroid exposure before and after commencing biologics were recorded. A clinically significant change in weight was defined as a change of ± 5% body weight from date of commencement of biological therapy. A super-responder was defined as exacerbation free and cessation of maintenance oral corticosteroids (mOCS) at one year, partial-responder as ≥ 50% reduction in exacerbations or ≥ 50% reduction in mOCS at one year, and a non-responder as patients who discontinued anti-IL5 treatment or did not fulfill response category. Results 71 patients were included in our analysis, 29 receiving mepolizumab and 43 benralizumab, with weight, height and BMI data recorded at a mean of 32 months (SD = 16.3, range 12-74 months) post biologic initiation. 53 patients (74.6%) were on mOCS. Mean weight decreased by -2.1kg (95% CI, −0.5 to 4.4; p = .07), with a mean BMI change of 0.7 (95% CI, −0.2 to 1.5; p = .13). There was no difference between mepolizumab and benralizumab treatment groups for change in percent weight (p = 0.6) or BMI (p = 0.20). 39 (54.9%) patients had no clinically significant change in body weight percentage, 15 (21.1%) patients had an increase and 17 (23.9%) patients had a decrease in body weight percentage. There was no association found between weight change and asthma response category (p = 0.76) or mOCS use prior to biologic initiation (p = 0.70). Conclusion In a real-world severe asthma cohort, anti-IL5/5Ra is associated with a small, insignificant reduction in weight. Clinical response, biologic agent, or mOCS use prior to initiation does not predict weight loss change. Patient education regarding additional interventions is necessary if weight change is desired. This abstract is funded by: None
Kerins et al. (Fri,) studied this question.