Background: Anxiety/depression are common comorbidities in severe asthma (SA).

Aim: To assess mepolizumab outcomes in SA stratified by anxiety/depression status.

Methods: Patients were stratified post hoc by anxiety/depression status (with/without), using data from REALITI-A, a 2-year international, prospective study, enrolling adults with asthma, newly prescribed mepolizumab (physician decision) 100 mg subcutaneously (index). Outcomes: rate of clinically significant exacerbations (CSEs; requiring systemic corticosteroids and/or hospitalisation/emergency room visit) 12 months pre- and 24 months post-index (follow-up); change from baseline (28 days pre-index) in maintenance oral corticosteroids (mOCS) daily dose at Weeks 101?104; change from baseline (90 days pre-index) in Asthma Control Questionnaire (ACQ)-5 score at Month 24.

Results: 203 (26%) patients reported anxiety/depression (Table); all outcomes improved during follow-up versus pre-index, regardless of comorbid status. At follow-up, patients with and without anxiety/depression, respectively, had 66% and 77% reduction in CSE rate from pre-index; 39% and 62% discontinued mOCS by Week 101?104; LS mean ACQ-5 scores reduced by 1.53 and 1.57 points by Month 24.

Conclusions: Real-world mepolizumab treatment was effective in SA with nominally greater improvements for those without versus with comorbid anxiety/depression.

Funding: GSK:204710