Efficacy of Intravenous Reslizumab in Oral Corticosteroid–Dependent Asthma

Parameswaran Nair, Philip Bardin, Marc Humbert, Kevin R. Murphy, Lisa Hickey, Margaret Garin, Rebecca Vanlandingham, Pascal Chanez

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Background: Reslizumab displays efficacy in patients with inadequately controlled eosinophilic asthma; previous reports in oral corticosteroid–dependent asthma are limited. Objective: To assess efficacy of reslizumab in oral corticosteroid–dependent patients and benefits on oral corticosteroid burden. Methods: We report post hoc analyses of pooled data from duplicate, placebo-controlled phase 3 trials. Patients aged 12 to 75 years with inadequately controlled, moderate-to-severe asthma were randomized 1:1 to receive intravenous reslizumab 3.0 mg/kg or placebo every 4 weeks for 52 weeks, stratified by oral corticosteroid use at enrollment and by region. Assessments included efficacy and predictors of clinical asthma exacerbation response in oral corticosteroid–dependent patients, and systemic corticosteroids burden in the overall population. Results: Patients were randomized to reslizumab (n = 477) or placebo (n = 476); 73 (15%) patients in each group were taking oral corticosteroids at baseline. Reslizumab was favored over placebo for all efficacy end points in oral corticosteroid–dependent patients, with numerically greater improvements in oral corticosteroid–dependent patients than the overall population. Having 2 or more versus 1 clinical asthma exacerbation in the previous 12 months was the strongest positive predictor of reduced exacerbation risk with reslizumab (risk reduction, 77.5% vs 15.2%; P ≤ .02). Significantly fewer new systemic corticosteroid prescriptions were issued per patient receiving reslizumab versus placebo (mean ± SD, 0.5 ± 1.07 vs 1.0 ± 1.52; P < .0001). Total and per-patient systemic corticosteroid burdens were lower: 121,135 versus 290,977 mg and 254 versus 611 mg/patient, respectively (both P < .0001). Conclusions: Oral corticosteroid–dependent patients benefited from reslizumab across asthma efficacy outcome measures. Reslizumab-treated patients required fewer new systemic corticosteroid prescriptions and had a lower systemic corticosteroid burden compared with placebo.

Original languageEnglish
Pages (from-to)555-564
Number of pages10
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume8
Issue number2
DOIs
Publication statusPublished - Feb 2020

Keywords

  • Eosinophil
  • IL-5
  • Oral corticosteroid
  • Prednisone
  • Reslizumab
  • Severe asthma

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