Mepolizumab Impact on Healthcare Resource Utilization and Work Productivity in Patients with Severe Asthma: REALITI-A 2-Year Analysis

OBJECTIVES: Healthcare resource utilization (HCRU) and activity impairment are higher among patients with severe asthma versus those with mild/moderate asthma. This analysis aimed to describe the long-term effect of mepolizumab (an anti-interleukin-5 monoclonal antibody) on these outcomes among patients with severe asthma over 24 months in the real world.

METHODS: REALITI-A was a prospective, observational study that enrolled patients with severe asthma initiating mepolizumab in real-world clinical practice. Outcomes included annual asthma-related and all-cause HCRU rates pre-initiation versus 24 months post-initiation (rate ratios [RR] and 95% confidence intervals [CI] were calculated), and the percentage change from baseline (≤90 days pre-initiation) in Work Productivity and Activity Impairment Questionnaire-Asthma (WPAI-A) scores at Month 24. A treatment policy estimand for treatment discontinuation was used, including data regardless of discontinuation.

RESULTS: The treated population comprised 822 patients; over 24 months, 223 discontinued mepolizumab. There were significant reductions in annual rates of asthma-related HCRU from pre-initiation (n=822) to 24 months post-initiation (n=820); hospitalizations reduced from 0.41 to 0.17 (RR [95% CI] 0.41 [0.33, 0.51]; p<0.001), emergency department visits from 0.56 to 0.20 (RR [95% CI] 0.36 [0.28, 0.45]; p<0.001), and outpatient visits from 4.99 to 1.86 (RR [95% CI] 0.37 [0.32, 0.44]; p<0.001). All-cause telephone call and home visit rates were similar pre- vs post-initiation: 1.09 vs 0.75 (RR [95% CI] 0.69 [0.47, 1.01]; p=0.056) and 0.12 vs 0.05 (RR [95% CI] 0.43 [0.16, 1.17]; p=0.100), respectively. In the limited number of patients with available data, mean (standard deviation) WPAI-A scores at Month 24 were reduced from baseline including activity impairment (31.3% [31.3] n=182), overall work impairment (28.0% [31.3]; n=67), impairment while working (27.2% [28.7]; n=67), and work time missed (4.2% [24.1]; n=70).

CONCLUSIONS: Mepolizumab reduced HCRU and improved work productivity and activity in patients with severe asthma in a real-world setting.