Treating Severe Eosinophilic Asthma: Mepolizumab vs Benralizumab - Pulmonology Advisor
Mepolizumab and benralizumab are highly effective for patients with severe eosinophilic asthma, according to a study presented at the American Thoracic Society (ATS) International Conference 2022, held in San Francisco, CA, May 13 to 18.
Mepolizumab, an anti-interleukin-5 (IL-5) antibody, and benralizumab, an anti-IL-5 receptor alpha antibody, are biologics approved for the treatment of severe eosinophilic asthma. The difference in treatment efficacy between these antibodies has yet to be elucidated.
Researchers in Japan therefore conducted a retrospective study to compare the clinical efficacy of these antibodies in patients with severe eosinophilic asthma. The researchers evaluated changes in asthma control test (ACT) scores and lung function at 4, 8, and 24 weeks after initiation of mepolizumab and benralizumab in 29 patients who received these antibodies between 2016 and 2021. Among the patients studied, 6 had switched from mepolizumab to benralizumab, and 3 patients had switched from benralizumab to mepolizumab.
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The researchers found that in newly treated patients, the mean ACT scores improved significantly after 4 weeks of treatment with both medications (from 18.8 to 20.9 in patients receiving mepolizumab [P =.011] and from 16.7 to 20.5 in patients receiving benralizumab [P <0.001]). This effect was sustained until 24 weeks. After 4 weeks of treatment, 75% of patients using mepolizumab and 71% of patients using benralizumab had ACT scores of 20 or more; after 24 weeks, the percentage of patients with ACT scores of 20 or more was 70% for mepolizumab and 77% for benralizumab.
With respect to patients who switched therapies, the researchers found that the 6 patients who switched from mepolizumab to benralizumab showed a significant improvement in mean ACT score after 8 weeks, from 14.5 to 21.8 (P =.023), while the percentage of patients with ACT scores of 20 or more increased from 17% to 83%. In the 3 patients who switched from benralizumab to mepolizumab "clinical outcomes tended to improve," noted study authors, although they did not give specifics regarding this improvement.
"Both mepolizumab and benralizumab were highly effective in severe asthma, with no clinically relevant differences in outcomes after 24 weeks of therapy," concluded the researchers.
Reference
Okawa K, Akamatsu T, Sugiyama S, et al. Comparison of clinical efficacy between mepolizumab and benralizumab in severe eosinophilic asthma. Presented at: the American Thoracic Society (ATS) 2022 International Conference; May 13-18, 2022; San Francisco, CA. Abstract P714.
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