Real-world effectiveness of reslizumab in patients with severe eosinophilic asthma: first Iinitiators and switchers

Hashimoto, S.; Kroes, J.A.; Eger, K.A.; Asam, P.F.M.; Hofstee, H.B.; Bendien, S.A.; ... ; RAPSODI Team (2022)

Article / Letter to editor

BACKGROUND: Reslizumab, a biologic targeting IL-5, has been shown to reduce asthma exacerbations and maintenance oral corticosteroid use in randomized controlled trials and pre-post studies in patients with severe eosinophilic asthma. However, real-world effectiveness data of reslizumab are scarce, and it is unknown whether reslizumab has added value after switching from another type 2 biologic.OBJECTIVE: To evaluate (1) the real-world effectiveness of reslizumab on severe asthma exacerbations, maintenance oral corticosteroid use, and overall treatment response, both in biologic-naive patients who initiated reslizumab and in those who switched from another type 2 biologic; and (2) physicians' experience with reslizumab treatment.METHODS: This observational real-world study evaluated data from 134 adults with severe eosinophilic asthma included in the Dutch severe asthma registry (RAPSODI), who initiated reslizumab treatment (4-weekly infusions, 0.3 mg/kg) before April 2020 and had follow-up data for 6 months and greater. Clinical asthma experts completed surveys on their experience with reslizumab treatment.RESULTS: Overall, reslizumab reduced the exacerbation rate (odds ratio [95% CI] = 0.10 [0.05-0.21]; P<.001), oral corticosteroid use (OR [95% CI], 0.2 [0.0-0.5]; P<.001), and maintenance dose (median [CI], 5.0 [0.0-10.0] to 0.0 [0.0-5.0]; P<.001), with comparable results in biologic-naive reslizumab initiators and switchers. The overall response to reslizumab was graded good or excellent in 59.2% of patients. The additive effectiveness of reslizumab after switching from another biologic was reflected in physicians' surveys.CONCLUSIONS: Real-world data show that reslizumab reduces severe asthma exacerbations and oral corticosteroid use in patients with severe eosinophilic asthma, both in biologic-naive reslizumab initiators and in those who switched from another type 2 biologic. This additional value of reslizumab was recognized by clinical asthma experts. (C) 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.

• Asthma
• Observational study
• Registries
• Biologic therapy
• IL-5
• Reslizumab
• Clinical effectiveness
• Glucocorticoids
• Exacerbations
• Survey

• All authors: Hashimoto, S.; Kroes, J.A.; Eger, K.A.; Asam, P.F.M.; Hofstee, H.B.; Bendien, S.A.; Braunstahl, G.J.; Broeders, M.E.A.C.; Imming, L.M.; Langeveld, B.; Maitland-Van der Zee, A.H.; Oud, K.T.M.; Patberg, K.W.; Smeenk, F.W.J.M.; Romme, E.A.P.M.; Bezouw, M.J. van; Ven, M.J. van de; Veen, A. van; Velzen, E. van; Veen, I.H.P.A.A. van; Weersink, E.J.M.; Brinke, A. ten; Sont, J.K.; Bel, E.H.; RAPSODI Team
• Date: 2022-08-09
• Journal: Journal of Allergy and Clinical Immunology: In Practice
• Volume: 10
• Issue: 8
• Pages: 2099 - 2108.e6
• DOI: doi:10.1016/j.jaip.2022.04.014