OBJECTIVES: Describe changes in activity and work productivity after Mepolizumab initiation across four eosinophilic diseases.

METHODS: 5 clinical study reports across 4 eosinophilic diseases [severe eosinophilic asthma (SEA), eosinophilic granulomatosis with polyangiitis (EGPA), chronic rhinosinusitis with nasal polyps (CRSwNP), and hypereosinophilic syndrome (HES)] evaluated changes in activity and work productivity after mepolizumab initiation [EGPA: MIRRA, CRSwNP: SYNAPSE, HES: FLARE, SEA: MENSA and REALITI-A. Randomized-placebo controlled trials (RCTs) [MIRRA, SYNAPSE, FLARE, MENSA] used the WPAI-GH (Work Productivity and Activity Index - General Health); REALITI-A, a prospective, real-world study, utilized WPAI-Asthma. Percent impairment was reported over 52 weeks for all studies, except FLARE and MENSA, which reported over 32 weeks.

RESULTS: Across all RCTs, mean changes from baseline mepolizumab vs placebo (PBO) (95% CI) for overall work impairment improved [EGPA: -1.92 (-12.67, 8.83), CRSwNP: -5.80 (-12.25, 0.64), HES: -7.51 (-26.90, 11.89), SEA: mepo: -5.80 vs. PBO: -0.68]. Impairment while working also improved across indications; greatest treatment difference observed in HES [-7.86 (-21.56, 5.85)]. CRSwNP, HES, and SEA patients had the greatest improvements in activity impairment compared to PBO [-7.80 (-12.67, -2.93), -16.59 (-26.39, -6.80), mepo: -13.70 vs. PBO: -5.70]. Regarding work time missed, EGPA and HES patients exhibited worsening relative to PBO [2.35 (-6.75, 11.44), 7.67 (-10.71, 26.05)], however <60% of patients with EGPA and HES reported employment. SEA and CRSwNP patients demonstrated improvements across all WPAI-GH categories. Considering real-world results, SEA patients (REALITI-A) demonstrated improvements from baseline across all WPAI-Asthma categories. Overall work impairment demonstrated the greatest improvements [mean change from baseline (95% CI) -23.38 (-27.64, -19.12)].

CONCLUSIONS: Mepolizumab decreases overall work impairment, and impairment while working across eosinophilic diseases in RCTs and the real-world, whereas benefits of work time missed, and activity impairment vary across indications.