dc.contributor.author | Thomas, Dennis | |
dc.contributor.author | Harvey, Erin S | |
dc.contributor.author | McDonald, Vanessa M | |
dc.contributor.author | Stevens, Sean | |
dc.contributor.author | Upham, John W | |
dc.contributor.author | Katelaris, Constance H | |
dc.contributor.author | Kritikos, Vicky | |
dc.contributor.author | Gillman, Andrew | |
dc.contributor.author | Harrington, John | |
dc.contributor.author | Hew, Mark | |
dc.contributor.author | Bardin, Philip | |
dc.contributor.author | Peters, Matthew | |
dc.contributor.author | Reynolds, Paul N | |
dc.contributor.author | Sivakumaran, Pathmanathan | |
dc.contributor.author | et al. | |
dc.date.accessioned | 2021-02-22T02:20:35Z | |
dc.date.available | 2021-02-22T02:20:35Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 2213-2198 | |
dc.identifier.doi | 10.1016/j.jaip.2021.01.028 | |
dc.identifier.uri | http://hdl.handle.net/10072/402445 | |
dc.description.abstract | BACKGROUND: Oral corticosteroids (OCS) carry serious health risks. Innovative treatment options are required to reduce excessive exposure and promote OCS stewardship. OBJECTIVES: This study evaluated the trajectories of OCS exposure (prednisolone-equivalent) in severe eosinophilic asthma patients before and after starting mepolizumab and the predictors of becoming OCS free after 6-months of mepolizumab therapy. METHODS: This real-world observational study included 309 patients from the Australian Mepolizumab Registry who were followed-up for one year (n=225). RESULTS: Patients had a median age of 60 (IQR 50,68) years, and 58% were female. At baseline, 48% used maintenance OCS, 96% had ≥1 OCS burst and 68% had received ≥1gram OCS in the previous year. After commencing mepolizumab, only 55% of those initially on maintenance OCS remained on this treatment by 12-months. Maintenance OCS dose reduced from median 10 (5.0,12.5) mg/day at baseline to 2 (0,7.0) mg/day at 12-months (p<0.001). Likewise, proportions of patients receiving OCS bursts in the previous year reduced from 96% at baseline to 50% at 12-months (p<0.001). Overall, 137 (48%) patients required OCS (maintenance/burst) after 6-months' mepolizumab therapy. Becoming OCS free was predicted by a lower body mass index (OR 0.925; 95%CI 0.872-0.981), late-onset asthma (1.027; 1.006-1.048), a lower Asthma Control Test score (1.111; 0.011-1.220) and not receiving maintenance OCS therapy at baseline (0.095; 0.040-0.227). CONCLUSION: Mepolizumab led to a significant and sustained reduction in OCS dependence in patients with severe eosinophilic asthma. This study supports the OCS-sparing effect of mepolizumab and highlights the pivotal role of mepolizumab in OCS stewardship initiatives. | |
dc.description.peerreviewed | Yes | |
dc.language | eng | |
dc.publisher | Elsevier BV | |
dc.relation.ispartofjournal | The Journal of Allergy and Clinical Immunology: In Practice | |
dc.subject.fieldofresearch | Dentistry | |
dc.subject.fieldofresearchcode | 3203 | |
dc.subject.keywords | OCS stewardship | |
dc.subject.keywords | Oral corticosteroid | |
dc.subject.keywords | mepolizumab | |
dc.subject.keywords | observational study | |
dc.subject.keywords | severe eosinophilic asthma | |
dc.title | Mepolizumab and oral corticosteroid stewardship - data from Australian Mepolizumab Registry | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dcterms.bibliographicCitation | Thomas, D; Harvey, ES; McDonald, VM; Stevens, S; Upham, JW; Katelaris, CH; Kritikos, V; Gillman, A; Harrington, J; Hew, M; Bardin, P; Peters, M; Reynolds, PN; Sivakumaran, P; et al., Mepolizumab and oral corticosteroid stewardship - data from Australian Mepolizumab Registry, The Journal of Allergy and Clinical Immunology: In Practice, 2021 | |
dcterms.dateAccepted | 2021-01-14 | |
dcterms.license | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.date.updated | 2021-02-21T23:35:41Z | |
dc.description.version | Accepted Manuscript (AM) | |
gro.description.notepublic | This publication has been entered as an advanced online version in Griffith Research Online. | |
gro.rights.copyright | © 2021 American Academy of Allergy, Asthma and Immunology. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. | |
gro.hasfulltext | Full Text | |
gro.griffith.author | Sivakumaran, Pathmanathan | |