The following is a summary of “Efficacy of mometasone/indacaterol/glycopyrronium in patients with inadequately controlled asthma with respect to baseline eosinophil count: Post hoc analysis of IRIDIUM study,” published in the June 2023 issue of Pulmonology by Kostikas, et al.

Baseline characteristics in asthma patients have the potential to guide treatment decisions. For an IRIDIUM study, researchers conducted a post hoc analysis, evaluating the impact of baseline eosinophil levels on the efficacy of mometasone/indacaterol/glycopyrronium (MF/IND/GLY) in patients with inadequately controlled asthma.

The analysis included a total of 3,065 patients. We compared the efficacy of high-dose MF/IND/GLY (160/150/50 μg, once-daily [o.d.]) to high-dose MF/IND (320/150 μg o.d.) and high-dose fluticasone/salmeterol (FLU/SAL [500/50 μg, twice-daily [b.i.d.]). Additionally, they evaluated the efficacy of pooled MF/IND/GLY (160/150/50 μg and 80/150/50 μg) versus pooled MF/IND (320/150 μg and 160/150 μg) in patient subgroups with baseline blood eosinophil count of <300 cells/μL or ≥300 cells/μL. At Week 26, high-dose MF/IND/GLY showed improved trough FEV1 compared to high-dose MF/IND (Δ78mL [<300 cells/μL]; Δ54mL [≥300 cells/μL]) and FLU/SAL (Δ112mL [<300 cells/μL]; Δ98mL [≥300 cells/μL]). Similarly, pooled MF/IND/GLY also showed improved trough FEV1 versus pooled MF/IND (Δ75mL [<300 cells/μL]; Δ68mL [≥300 cells/μL]).

Over 52 weeks, high-dose MF/IND/GLY reduced the annualized rate of moderate or severe asthma exacerbations by 23% and 10%, severe exacerbations by 31% and 15%, and all exacerbations by 33% and 10%, compared to high-dose MF/IND for subgroups with <300 cells/μL and ≥300 cells/μL, respectively. Similarly, pooled MF/IND/GLY reduced exacerbations by 22% and 8%, 21% and 7%, 27% and 8%, versus pooled MF/IND, for the respective subgroups.

The results indicated that MF/IND/GLY improved lung function and reduced asthma exacerbations compared to MF/IND and FLU/SAL, regardless of baseline eosinophil levels. It suggested that baseline eosinophil levels did not influence the efficacy of MF/IND/GLY in patients with inadequately controlled asthma.

Source: resmedjournal.com/article/S0954-6111(23)00222-6/fulltext