Mepolizumab has clinical benefits including oral corticosteroid sparing irrespective of baseline EGPA characteristics.
ERJ Open Res
; 10(1)2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-38196889
ABSTRACT
Background:
The Mepolizumab in Relapsing or Refractory EGPA (MIRRA) trial (GSK ID 115921/NCT02020889) demonstrated that mepolizumab increased remission time and reduced oral corticosteroid (OCS) use compared with placebo in patients with relapsing or refractory eosinophilic granulomatosis with polyangiitis (EGPA). The present analysis investigated the impact of baseline characteristics on clinical outcomes and characterised the OCS-sparing effect of mepolizumab.Methods:
In a phase 3, randomised controlled trial for patients with EGPA (MIRRA), patients received standard of care plus mepolizumab 300â mg or placebo every 4â weeks for 52â weeks. The accrued duration of remission, the proportion of patients in remission at weeks 36 and 48, and the proportion of patients with clinical benefit (remission, OCS or relapse-related) were assessed according to baseline EGPA characteristic subgroups (post hoc). Mepolizumab-related OCS-sparing benefits were also quantified.Results:
Accrued duration of remission and the proportion of patients in remission at weeks 36 and 48 were greater with mepolizumab than placebo across the baseline subgroups of refractory disease, immunosuppressant use, EGPA duration, relapse number and OCS use ≤20â mg·day-1. The proportion of patients with clinical benefit was greater with mepolizumab versus placebo (range 76-81% versus 25-39%), irrespective of immunosuppressant use or EGPA duration. Patients treated with mepolizumab versus placebo accrued significantly more weeks on OCS ≤4â mg·day-1 (OR 5.06, 95% CI 2.47-10.38) and had a mean of 1423.1â mg less per-patient OCS exposure over 52â weeks.Conclusions:
Mepolizumab treatment provided benefits to patients with EGPA across varying baseline clinical characteristics and can be considered an OCS-sparing treatment in EGPA.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
Idioma:
En
Revista:
ERJ Open Res
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Reino Unido