Mepolizumab in patients with asthma and features of COPD: A MENSA/MUSCA post hoc analysis

<bold>Background:</bold> Mepolizumab improved exacerbation rate and quality of life vs standard of care (SOC) in patients with severe asthma in Phase 3/4 studies MENSA/MUSCA (<ext-link>NCT01691521</ext-link>/NCT02281318). <bold>Aims and Objectives:</bold> Assess the effect of mepolizumab in patients with severe asthma stratified by presence/absence of COPD-like features (CLF). <bold>Methods:</bold> Post hoc analysis included patients receiving mepolizumab (100 mg SC) or SOC Q4W for 32 or 24 weeks (MENSA/MUSCA). CLFs were defined as aged ≥40 years, FEV1/FVC <0.7, post-bronchodilator (BD) predicted FEV1 <80% and poor BD reversibility <12% or 200 mL. Endpoints included change from baseline in annual exacerbation rate (AER), SGRQ score and pre-BD FEV1. <bold>Results:</bold> At baseline, 83/468 patients receiving mepolizumab had CLF vs 104/468 for SOC. AER was significantly reduced from baseline with mepolizumab vs SOC (pooled MENSA/MUSCA; rate ratio [95% CI]: 0.45 [0.28, 0.71] with CLF vs 0.43 [0.34, 0.55] without). SGRQ score similarly improved from baseline with mepolizumab vs SOC for those with and without CLF in MENSA (difference [95% CI]: −10.1 [−21.5, 1.2] vs −6.6 [−9.9, −3.2]) and MUSCA (−8.3 [−13.7, −2.9] vs −8.1 [−11.3, −4.8]). Similar FEV1 improvements were seen in both CLF groups (Figure). <bold>Conclusions:</bold> With mepolizumab, exacerbation rate, SGRQ and lung function were similarly improved for patients with and without CLF. <fig><object-id>erj;64/suppl_68/PA4492/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>