The real world effectiveness and effect on adherence with inhaled asthma therapy of 1 year of Severe Asthma Monoclonal Antibody Treatment

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Introduction & Aim: In the UK there are 4 monoclonal antibodies (MAbs) approved to treat severe asthma. We aim to describe the efficacy of these agents in real world clinical practice. Methods: We conducted a retrospective review of pateints who received MAbs for 1 year. Statistical comparisons were carried out on GraphPad Prism v5.0. Continous data (FEV1, number of exacerbations requiring OCS and AQLQ) was compared using a Student’s T test or Man Whitney test following normality testing. Binary data (long term OCS dose & medication prescription collection rate) was compared using Fishers Exact. Results: We assessed 40 patients at 1 year; 52.5% mepolizumab, 22.5% omalizumab, 17.5% benralizumab and 7.5% reslizumab. There was a statistically significant decrease in eosinophil count from 0.6 to 0.09 (p= <0.0001) Number of exacerbations declined from 4.8 to 1.9 (p= <0.0001). When stratified, all MAB’s led to a reduction in exacerbations; benralizumab from 4.7 to 1.7 (p= 0.004); mepolizumab from 5.1 to 2.0 (p=0.009), reslizumab from 3.7 to 1.0 (p= 1.00), omalizumab from 4.8 to 2.4 (p= 0.068). mAQLQ scores increased from 2.9 to 4.2 (p= 0.0002) and mean long term OCS dose (mg) reduced from 8.58 to 5.93 (p = 0.0724). There was no significant change in FEV1 and 91.4% of patients had good adherence to asthma medication at 1 year (GP prescription rate of ≥80%). Conclusion: Clinical trial data for Asthma MAB therapies are borne out in our real world population. <10% of patients had demonstrably reduced adherence to non-MAb asthma medication at 1 year and there are significant improvements in quality of life.

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