Clinical Remission is Achievable for Adult Patients with Severe Asthma Receiving Mepolizumab: A European...

The introduction of precision therapy in severe asthma is shifting treatment goals from asthma control towards the more ambitious target of clinical remission. This study evaluated clinical remission in patients with severe asthma receiving mepolizumab in Europe.

A retrospective, physician panel-based chart review was conducted based on anonymised data from patients who initiated mepolizumab in Italy, Germany, and France from 30 June 2017 to 30 June 2022. Primary outcome was clinical remission at Year 1 post-initiation, defined as the absence of severe or clinically significant asthma exacerbations, no maintenance oral corticosteroid use in Month 12, and an Asthma Control Test score ≥ 20, plus either lung function stabilisation (no worsening of forced expiratory volume in 1 s [FEV₁] from baseline) or lung function optimisation (FEV₁ ≥ 80% predicted). Individual components of clinical remission were compared before versus after mepolizumab initiation, and clinical remission at Year 2 was also assessed.

Data from 308 patients were included by 117 physicians. Clinical remission based on lung function stabilisation was achieved by 37.8% of patients (101/267) at Year 1 and 58.7% (108/184) at Year 2. Remission based on lung function optimisation was achieved by 18.8% (58/308) at Year 1 and 28.6% (55/192) at Year 2. Regardless of the lung function definition used, ≥ 90% of patients who achieved remission at Year 1 maintained it until Year 2 (among those with evaluable data). Individual components of clinical remission, including FEV₁ ≥ 80% predicted, showed significant improvements at 12 months compared with baseline (all p < 0.001).

This real-world study demonstrates that clinical remission is an ambitious and achievable treatment goal for patients with severe asthma treated with mepolizumab in Europe. Graphical abstract available for this article.