In an indirect treatment comparison (ITC) of 3 drugs for severe eosinophilic asthma, GlaxoSmithKline’s (GSK) mepolizumab, marketed as Nucala, reduced exacerbations by 34% to 45% compared with reslizumab or benralizumab. The results were published in The Journal of Allergy and Clinical Immunology.
Reslizumab is sold under the name Cinqair by Teva, and benralizumab is sold under the name Fasenra by AstraZeneca.
Eosinophilic asthma is a severe form of the condition that doesn’t respond well to inhaled corticosteroids, even at high doses. White blood cells called eosinophils become overactive, causing inflammation that blocks the airway with fluid and mucous. This can cause bronchial spasms. Unlike forms of asthma that are riggered by allergies or an environmental reaction, patients with this condition do not typically have a history of allergies.
All 3 drugs are monoclonal antibodies targeting interleukin-5, a type-1 cytokine that plays a key role in the triggering eosinophilic airway inflammation.
The latest news about mepolizumab follows Friday’s announcement that the FDA wants more clinical data before it will consider it for chronic obstructive pulmonary disease (COPD). An FDA advisory committee voted against approving the drug for COPD in July.
The ITC used data from a Cochrane review and independent searches, totaling 11 studies. Eligible studies were randomized, controlled trials in patients 12 years or older.
Endpoints included the annualized rate of clinically significant exacerbations and a change from baseline in Asthma Control Questionnaire (ACQ) score and forced expiratory volume in 1 second (FEV1). Patients were included if they had an ACQ ≥1.5; they were stratified by baseline blood eosinophil counts.
The study showed that all 3 drugs significantly reduced clinically significant exacerbations, and improved asthma control and lung function versus placebo.
In a statement, GSK said the comparisons were performed on “patient populations grouped by baseline blood eosinophil count, which is known to influence treatment effect, and matched according to baseline ACQ score to allow like-for-like comparisons between treatments.”