Real-world impact of mepolizumab on pediatric and adolescent patients with severe asthma
The Journal of Allergy and Clinical Immunology, 2025
Background
Real-world evidence on the effectiveness of mepolizumab in children and adolescents with severe asthma (SA) is limited.
Objective
We sought to evaluate mepolizumab's impact on the clinical and health care resource utilization (HCRU) burden of SA in children and adolescents.
Methods
A retrospective study (GSK ID: 218952) was conducted of US administrative claims for patients aged 6-17 years with SA who initiated mepolizumab (from October 1, 2016, to June 30, 2023), had continuous health plan enrollment for ≥12 months pre- and post-mepolizumab initiation, and had ≥1 additional mepolizumab dispensings/administrations ≤6 months from initiation. Rate ratios from Poisson regression models were used to compare asthma exacerbations, oral corticosteroid (OCS) dispensings and bursts, short-acting β2-agonist (SABA) canister use, and HCRU per patient-year (PPY) pre- and post-mepolizumab; risk ratios from log-binomial regression models compared proportions of patients with ≥1 OCS dispensings and ≥1 SABA canister dispensings between periods.
Results
Of 580 patients, 47% were aged 6-11 years and 53% were aged 12-17 years. Mean OCS dispensings PPY decreased by 24% (P < .001) pre- versus post-mepolizumab initiation. Mean overall asthma exacerbations and OCS bursts PPY decreased by 34% and 29% (P < .001 each), respectively. The proportions of patients with ≥1 OCS dispensings and those using ≥1 SABA canisters decreased by 16% (P < .001) and 3% (P = .039), respectively. Asthma-related HCRU PPY decreased by 23% for inpatient visits (P = .031), 15% for emergency department visits (P = .021), and 26% for outpatient visits (P < .001).
Conclusions
Mepolizumab initiation was associated with significant reductions in asthma exacerbations, OCS and SABA use, and HCRU in children and adolescents with SA, demonstrating real-world clinical benefit.
Authors
Hernandez ML, Corbridge T, Laliberté F, Mahendran M, Hilts A, Zhang K, Deb A