|Title:||A retrospective review of clinical outcomes in patients switched from Omalizumab to Anti-interleukin-5 therapy in a regional asthma specialist centre|
|Author(s):||E. O’Reilly, D. Casey, A. McGrath, T. McHugh, P. Vairamani, J. Murphy, B. Plant, D. Murphy|
|Institution:||Cork University Hospital Department of Respiratory Medicine/ Health Research Board, Clinical Research Facility, University College Cork|
|Poster:||Click to view poster|
|Abstract:||Interleukin-5 (IL-5) is a pro-eosinophilic cytokine that contributes to inflammation in the airways. First approved for HSE reimbursement in 2018, anti-IL-5 therapies allow for targeted asthma care in carefully selected patients with refractory disease.|
We assessed clinical outcomes in severe eosinophilic asthmatics who remained suboptimally controlled despite Omalizumab and were therefore switched to Anti-IL-5 therapy.
All patients who switched therapy were reviewed (2018-2021). Asthma Control Questionnaire (ACQ), exacerbation rate, eosinophil count, maintenance corticosteroid (OCS) dose, and FEV1 were analysed. Comparisons were made pre Omalizumab vs one year established on Omalizumab and pre switch on Omalizumab vs. one year post anti-IL-5 commencement.
Ten patients met criteria. All switched therapy September 2018-September 2020. Six patients commenced Benralizumab, and four commenced Mepolizumab.
There was a significant reduction in exacerbation rate, eosinophil count, and FEV1 in Omalizumab vs. one year post anti-IL-5, (p=0.005, p=0.007, p=0.046) respectively.
Median annual exacerbation rate decreased from pre Omalizumab to one year post (10 vs. 5) and from pre anti-IL-5 to post (6 vs. 0). Median OCS dose decreased from pre anti IL-5 to post (7.5 vs. 2.5mg ). Median ACQ score decreased (3.0 vs 1.9).
Asthmatics who are suboptimally controlled despite Omalizumab should be considered for anti-IL5 therapy.