The following is a summary of “Long-Term Clinical and Sustained REMIssion in Severe Eosinophilic Asthma treated with Mepolizumab: The REMI-M study,” published in the August 2024 issue of Allergy and Immunology by Crimi et al.

Biological therapies, such as mepolizumab, have revolutionized the treatment landscape for severe eosinophilic asthma, offering significant short-term benefits. Despite established short-term efficacy, more information must be given regarding its long-term effectiveness and potential for achieving sustained clinical remission. This study aims to assess mepolizumab’s long-term effectiveness and safety, evaluate its potential to induce and maintain clinical remission and identify baseline factors predictive of remission over 24 months. The REMI-M study is a retrospective, real-world, multicenter analysis involving 303 patients with severe eosinophilic asthma treated with mepolizumab. 

Clinical outcomes, demographics, and safety data were collected at baseline, 3, 6, 12, and 24 months. Clinical remission was defined by various criteria, including the absence of exacerbations, no oral corticosteroid (OCS) use, and satisfactory asthma control, with or without lung function assessments. Sustained remission was characterized as achieving clinical remission at 12 months and maintaining it through 24 months. The results showed that clinical remission rates varied between 28.6% and 43.2% at 12 months and 26.8% and 52.9% at 24 months, depending on the remission criteria. Sustained remission was observed in 14.6% to 29% of patients. Key factors associated with achieving clinical remission included the presence of aspirin-exacerbated respiratory disease, better baseline lung function, male sex, absence of anxiety/depression, presence of gastroesophageal reflux disease, bronchiectasis, and reduced OCS consumption. 

Adverse events related to mepolizumab were infrequent. This study highlights the real-world effectiveness of mepolizumab in achieving and maintaining clinical remission in severe eosinophilic asthma over 24 months. Identifying baseline factors linked to remission underscores the importance of addressing comorbid conditions and appropriately selecting patients for biologic therapy.

Source: sciencedirect.com/science/article/pii/S2213219824008523