@Article {Harvey1902420，作者= {Harvey，Erin S.和Langton，David和Katelis，Contance和Stevens，Sean和Farah，Claude S.和Gillman，Andrew和Harrington，John和Hew，Mark和Kritikos，Vicky和Radhakrishna，Naghmeh和Bardin，Philip和Peters，Matthew和Reynolds，Paul N.和Upham，John W.和Baraket，Melissa和Bowder，Simon和Bowden，Jeffrey和Chien，Jimmy和Chung，Li Ping和Graing，Christopher和Jenkins，Christineand Katsoulotos, Gregory P. and Lee, Joy and McDonald, Vanessa M. and Reddel, Helen K. and Rimmer, Janet and Wark, Peter A.B. and Gibson, Peter G.}, title = {Mepolizumab effectiveness and identification of super-responders in severe asthma}, volume = {55}, number = {5}, elocation-id = {1902420}, year = {2020}, doi = {10.1183/13993003.02420-2019}, publisher = {European Respiratory Society}, abstract = {Severe asthma is a high-burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population.The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia.Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58\% female) commenced mepolizumab. They had poor symptom control (median Asthma Control Questionnaire (ACQ)-5 score of 3.4), frequent exacerbations (median three courses of oral corticosteroids (OCS) in the previous 12 months), and 47\% required daily OCS. Median baseline peripheral blood eosinophil level was 590 cells{\textperiodcentered}{\textmu}L-1. Comorbidities were common: allergic rhinitis 63\%, gastro-oesophageal reflux disease 52\%, obesity 46\%, nasal polyps 34\%.Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95\% CI 0.29{\textendash}0.41); p\<0.001) and hospitalisations (rate ratio 0.46 (95\% CI 0.33{\textendash}0.63); p\<0.001). Treatment improved symptom control (median ACQ-5 reduced by 2.0 at 6 months), quality of life and lung function. Higher blood eosinophil levels (p=0.003) and later age of asthma onset (p=0.028) predicted a better ACQ-5 response to mepolizumab, whilst being male (p=0.031) or having body mass index >=30 (p=0.043) predicted a lesser response. Super-responders (upper 25\% of ACQ-5 responders, n=61, 24\%) had a higher T2 disease burden and fewer comorbidities at baseline.Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.In clinical practice, mepolizumab reduces the burden of severe eosinophilic asthma by reducing severe exacerbations and improving asthma control, quality of life and lung function. Super-responders have a T2 phenotype and few comorbidities. http://bit.ly/2UIio4x}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/55/5/1902420}, eprint = {//www.qdcxjkg.com/content/55/5/1902420.full.pdf}, journal = {European Respiratory Journal} }