Real-World Effectiveness of Reslizumab in Patients with Severe Eosinophilic Asthma - "First Initiators" and "Switchers"

BACKGROUND: Reslizumab, a biologic targeting interleukin-5 has been shown to reduce asthma exacerbations and maintenance oral corticosteroid (OCS) 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) real-world effectiveness of reslizumab on severe asthma exacerbations, maintenance OCS-use and overall treatment response, both in biologic naïve patients who initiated reslizumab, and in patients who switched from another type-2 biologic. (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 ≥6 months. Clinical asthma experts completed surveys on their experience with reslizumab treatment. RESULTS: Overall, reslizumab reduced exacerbation rate (OR(95%CI): 0.10(0.05-0.21), p<0.001), oral corticosteroid use (OR(95%CI) 0.2(0.0-0.5), p<0.001) and maintenance dose, median(CI): 5.0(0.0-10.0) to 0.0(0.0-5.0), p<0.001), with comparable results in biologic-naïve 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. CONCLUSION: Real-world data show that reslizumab reduces severe asthma exacerbations and oral corticosteroid use in patients with severe eosinophilic asthma, both in biologic-naïve reslizumab initiators and in those who switched from another type-2 biologic. This additional value of reslizumab was recognized by clinical asthma experts

Real-World Effectiveness of Reslizumab in Patients with Severe Eosinophilic Asthma - "First Initiators" and "Switchers"

BACKGROUND: Reslizumab, a biologic targeting interleukin-5 has been shown to reduce asthma exacerbations and maintenance oral corticosteroid (OCS) 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) real-world effectiveness of reslizumab on severe asthma exacerbations, maintenance OCS-use and overall treatment response, both in biologic naïve patients who initiated reslizumab, and in patients who switched from another type-2 biologic. (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 ≥6 months. Clinical asthma experts completed surveys on their experience with reslizumab treatment. RESULTS: Overall, reslizumab reduced exacerbation rate (OR(95%CI): 0.10(0.05-0.21), p<0.001), oral corticosteroid use (OR(95%CI) 0.2(0.0-0.5), p<0.001) and maintenance dose, median(CI): 5.0(0.0-10.0) to 0.0(0.0-5.0), p<0.001), with comparable results in biologic-naïve 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. CONCLUSION: Real-world data show that reslizumab reduces severe asthma exacerbations and oral corticosteroid use in patients with severe eosinophilic asthma, both in biologic-naïve reslizumab initiators and in those who switched from another type-2 biologic. This additional value of reslizumab was recognized by clinical asthma experts