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Mepolizumab exhibits quantifiable reduction in corticosteroid-related adverse effects in severe asthma

Year: 2026

Type: article

Abstract: BACKGROUND: Treatment that reduces systemic corticosteroid (SCS)-related adverse effects but maintains disease control is of broad public health importance. OBJECTIVE: To evaluate the effect of mepolizumab vs long-term SCS use on SCS-related adverse effects in patients with severe asthma. METHODS: This retrospective, longitudinal cohort study (GSK Identification: US 218950) used claims data from the Optum Clinformatics Data Mart database from November 2014 to December 2022. Eligible patients (aged ≥12 years with ≥2 asthma diagnostic claims), had at least 2 mepolizumab claims (mepolizumab-treated cohort) or at least 6 months of continuous SCS use (long-term SCS-treated cohort). Inverse probability of treatment weighting was used to balance cohort characteristics. The primary outcome was SCS-related adverse effects. The secondary outcomes included exacerbation frequency, SCS/oral corticosteroid use, healthcare resource utilization, and costs (excluding the cost of therapy). RESULTS: Overall, 1219 (mepolizumab-treated) and 835 (long-term SCS-treated) patients with severe asthma were included (median follow-up, 12 months). Cohorts were well-balanced after weighting (mean age, 63-65 years; 66% female). The mepolizumab-treated cohort had significant reductions in overall, acute, and long-term SCS-related adverse effects (rate ratio [CI] 0.80 [0.70-0.92], 0.63 [0.47-0.84], and 0.80 [0.70-0.92], respectively) vs the long-term SCS-treated cohort; SCS dose reduction of 4.7 mg/d corresponds to a 20% reduction in SCS-related adverse effects (P = .002). Similar trends were observed in exacerbation rates, healthcare resource utilization, and medical costs, although not all reached statistical significance. CONCLUSION: Mepolizumab treatment reduced acute and long-term corticosteroid effects in patients with severe asthma vs long-term SCS use, suggesting avoidance of corticosteroid use can lead to measurable regression of SCS-associated adverse effects and more favorable disease trajectory.

Source: Annals of Allergy Asthma & Immunology

DOI: 10.1016/j.anai.2026.03.024