Disease remission in severe asthma patients on mepolizumab treatment and its duration after treatment discontinuation.

Introduction: Despite the proven efficacy of mepolizumab (MEPO) in severe asthma, the proportion of patients achieving multi-component endpoints of disease remission(DR) and its duration after treatment discontinuation (TD) remains unclear, especially in real-world settings.

Aim: To examine the proportion of severe asthmatics achieving DR after 2 years of treatment with MEPO, followed by the time to the first loss of asthma control after TD.

Methods: A retrospective analysis of data collected during the 2 years of MEPO treatment and 6 months after TD was carried out among patients qualified for biological treatment in line with Polish reimbursement regulations. Up to 2022, it was obligatory to suspend the therapy after 2 years of treatment. The following five DR components were evaluated: blood eosinophils <300 cells/µL, no need for oral corticosteroids (OCS), zero exacerbations requiring OCS and hospitalizations, the Asthma Control Questionnaire score <1,5, and pre-bronchodilator forced expiratory volume in 1 sec increase ?100 mL.

Results: Overall, 47 patients receiving MEPO were included in this analysis, of which 8 (17%) discontinued treatment within one year due to lack of efficacy. After one year of MEPO therapy, 22 (47%) achieved DR, which was maintained for the next year of treatment. In remittent patients, the median time to loss of DR after TD was 2.5 months and 20 (91%) returned to MEPO.

Conclusion: The presented analysis indicates the high effectiveness of MEPO in achieving DR, which, however, persists relatively shortly after TD.