Evaluation of therapeutic response to anti-IL5 treatment in severe eosinophilic asthma patients no responders to omalizumab

Methods: A restrospective analysis of 15 severe eosinophilic asthma patients treated previously with omalizumab with no satisfactory response or adverse events. They were switched to mepolizumab 100mg every 4 weeks or reslizumab 3mg/kg every 4 weeks. Demographic data, comorbidities, sensitization, asthma control test (ACT), quality life test (AQLQ), eosinophil and immunoglobulin E measurements, pulmonary function results, nitric oxide measurements, use of systemic corticosteroids and exacerbations previous and 1 year post anti-IL5 treatment. Results: Median on ACT pre anti-IL5 treatment was 12 (Q1:10; Q3:17) and post anti-IL5 was 21 (Q1:19; Q3:23). Median on AQLQ pre anti-IL5 was 3,9 (Q1:2,5; Q3:5,5) and post anti-IL5 5,6 (Q1:4;Q3:6,2). Median on exacerbations that required systemic corticosteroid pre anti-IL5 treatment was 3 (Q1:3;Q3:5) and post anti-IL5 was 0 (Q1:0;Q3:1). Median of exacerbations that required visiting an emergency service or hospitalization pre anti-IL5 was 2 (Q1:0;Q3:1) and post anti-IL5 was 0 (Q1:0;Q3:1). Reduction on oral corticosteroid dose was 5,8mg/day (CI 95%: 2,7; 8,9) on average 1 year post treatment. Statistical significance was observed in ACT and AQLQ change (p<0,001) and number of exacerbations(p<0,002) in Wilcoxon rank sum test. Statistical significance (p<0,004) was observed in corticoisteroid dose pre anti-IL5 and post anti-IL5 with Bonferroni post-hoc test. Conclusion: Anti-IL5 treatment in eosinophilic asthma patients with no satisfactory response to omalizumab improves asthma control and quality of life. It also reduces oral corticosteroid dose and exacerbation rate.