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dc.contributor.authorThomas, Dennis
dc.contributor.authorHarvey, Erin S
dc.contributor.authorMcDonald, Vanessa M
dc.contributor.authorStevens, Sean
dc.contributor.authorUpham, John W
dc.contributor.authorKatelaris, Constance H
dc.contributor.authorKritikos, Vicky
dc.contributor.authorGillman, Andrew
dc.contributor.authorHarrington, John
dc.contributor.authorHew, Mark
dc.contributor.authorBardin, Philip
dc.contributor.authorPeters, Matthew
dc.contributor.authorReynolds, Paul N
dc.contributor.authorSivakumaran, Pathmanathan
dc.contributor.authoret al.
dc.date.accessioned2021-02-22T02:20:35Z
dc.date.available2021-02-22T02:20:35Z
dc.date.issued2021
dc.identifier.issn2213-2198
dc.identifier.doi10.1016/j.jaip.2021.01.028
dc.identifier.urihttp://hdl.handle.net/10072/402445
dc.description.abstractBACKGROUND: 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.peerreviewedYes
dc.languageeng
dc.publisherElsevier BV
dc.relation.ispartofjournalThe Journal of Allergy and Clinical Immunology: In Practice
dc.subject.fieldofresearchDentistry
dc.subject.fieldofresearchcode3203
dc.subject.keywordsOCS stewardship
dc.subject.keywordsOral corticosteroid
dc.subject.keywordsmepolizumab
dc.subject.keywordsobservational study
dc.subject.keywordssevere eosinophilic asthma
dc.titleMepolizumab and oral corticosteroid stewardship - data from Australian Mepolizumab Registry
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationThomas, 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.dateAccepted2021-01-14
dcterms.licensehttp://creativecommons.org/licenses/by-nc/4.0/
dc.date.updated2021-02-21T23:35:41Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis 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.hasfulltextFull Text
gro.griffith.authorSivakumaran, Pathmanathan


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