Effectiveness of Mepolizumab in patients with late-onset severe eosinophilic asthma and fixed obstruction, a 2-Year Follow-Up: The MESILICO study

<bold>Purpose:</bold> We investigated the efficacy of Mepolizumab treatment in severe asthmatics by assessing patient characteristics associated with treatment response. <bold>Methods:</bold> MESILICO is a multicenter study including 8 Pulmonary Clinics in Greece. Patients with late-onset severe eosinophilic asthma and fixed obstruction were eligible to be administered Mepolizumab. Forty-seven patients were recruited in MESILICO study. Clinical parameters such as spirometry values (FEV1, FVC, PEF, MEF), ACT value, biomarkers of inflammation (blood eosinophils, FENO, IgE) were evaluated before and after treatment initiation. This trial is registered with ClinicalTrials.gov, number <ext-link>NCT04612556</ext-link>. <bold>Results:</bold> Forty-five patients concluded 12 months of mepolizumab treatment. The majority of the asthmatics were women (85%) of mean age 57.4 ± 11 years. After 12 months, mepolizumab treatment was associated with clinical improvement, with, in comparison to the year pre-mepolizumab initiation, a significant reduction in severe disease exacerbation (67%) along with significant improvements in lung function and asthma control score (p<0.001). Mepolizumab treatment was also associated with a significant decrease in blood eosinophils and FeNO (p<0.001). Forty-three patients concluded 24 months of mepolizumab treatment. At 2-year follow-up, no significant changes were observed in all parameters, and clinical improvement was stable. No new safety signals were observed in this study. <bold>Conclusions:</bold> These data demonstrate that 2 years follow up of mepolizumab treatment improves the clinical outcomes of patients with late-onset severe eosinophilic asthma and fixed obstruction. Efficacy of mepolizumab in this real-world study is consistent with previous studies in other phenotypes of severe asthmatics. <bold>Funding:</bold> GSK 214163.