Ishii Tomonori, Kunishige Hideaki, Kobayashi Tamami, Hayashi Etsuko, Komatsubara Masaki, Ishii Takeo, Alfonso-Cristancho Rafael, Tamaoki Jun, Howarth Peter
Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.
Value Evidence & Outcomes, GSK, Tokyo, Japan.
Mod Rheumatol. 2024 Aug 20;34(5):978-987. doi: 10.1093/mr/road109.
The objective of the study is to assess real-world, long-term safety/effectiveness of mepolizumab for eosinophilic granulomatosis with polyangiitis (EGPA) in Japan.
The Mepolizumab long-term study to Assess Real-world Safety and effectiveness of EGPA in Japan (MARS) (GSK ID: 213684/NCT04551989) is an ongoing 96-week study of patients with EGPA who received four-weekly mepolizumab 300 mg subcutaneously for ≥96 weeks before study entry (baseline) and continued treatment. This interim analysis included safety from baseline to Week 48 (observation period) and clinical outcomes before mepolizumab and during the observation period.
Of 118 patients enrolled, 29% (34/118) experienced adverse events (AEs), of which 13% (15/118) experienced serious AEs; none were considered mepolizumab related. The median oral corticosteroid (OCS) dose decreased from 6.9 (pre-mepolizumab) to 3.0 (baseline) and 2.0 mg/day (Weeks 45-48); the proportion of patients receiving no OCS increased from 8% to 32% and 38%, respectively. Patients experiencing clinical symptoms decreased from 94% (pre-mepolizumab) to 73% (baseline) and 67% (Week 48). During the observation period, 5% of patients experienced EGPA relapse; the rates of EGPA-related hospitalisations, EGPA-related emergency room/unscheduled visits, and asthma exacerbations were 0.05, 0.09, and 0.08 event/person-year, respectively.
The results of mepolizumab treatment for ≥144 weeks (before baseline plus observation) were consistent with the known safety profile and allowed OCS dose reduction while improving disease control versus pre-treatment among patients with EGPA.
本研究的目的是评估美泊利珠单抗在日本治疗嗜酸性肉芽肿性多血管炎(EGPA)的真实世界长期安全性/有效性。
美泊利珠单抗在日本评估EGPA真实世界安全性和有效性的长期研究(MARS)(GSK ID:213684/NCT04551989)是一项正在进行的为期96周的研究,研究对象为EGPA患者,这些患者在研究入组(基线)前接受皮下注射300mg美泊利珠单抗,每四周一次,持续≥96周,并继续接受治疗。本次中期分析包括从基线到第48周(观察期)的安全性以及美泊利珠单抗治疗前和观察期的临床结局。
在118名入组患者中,29%(34/118)经历了不良事件(AE),其中13%(15/118)经历了严重AE;均未被认为与美泊利珠单抗相关。口服糖皮质激素(OCS)的中位剂量从6.9(美泊利珠单抗治疗前)降至3.0(基线)和2.0mg/天(第45 - 48周);未接受OCS治疗的患者比例分别从8%增加到32%和38%。出现临床症状的患者从94%(美泊利珠单抗治疗前)降至73%(基线)和67%(第48周)。在观察期内,5%的患者经历了EGPA复发;EGPA相关住院、EGPA相关急诊室/非计划就诊以及哮喘加重的发生率分别为0.05、0.09和0.08事件/人年。
美泊利珠单抗治疗≥144周(基线前加观察期)的结果与已知安全性概况一致,在EGPA患者中与治疗前相比,可降低OCS剂量,同时改善疾病控制。