OP0148 MEPOLIZUMAB FOR EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA): A RETROSPECTIVE REAL-WORLD EUROPEAN STUDY ON 142 PATIENTS
Authors: A. Bettiol, M. L. Urban, F. Alberici, C. Agostini, C. Baldini, E. Bozzolo, P. Cameli, N. Crimi, S. Del Giacco, A. Egan, G. Espigol-Frigole, M. Felicetti, M. Folci, P. Fraticelli, M. Govoni, A. Kernder, C. Lombardi, G. Lopalco, C. Lunardi, A. J. Mohammad, F. Moosig, S. Negrini, T. Neumann, P. Novikov, G. Paolazzi, P. Parronchi, L. Quartuccio, V. Racanelli, C. Salvarani, M. Samson, J. Schroeder, S. Sciascia, R. A. Sinico, B. Terrier, P. Toniati, D. Prisco, A. Vaglio, G. Emmi
Journal: Annals of the Rheumatic Diseases (2020)

Background: Evidence on the efficacy of Mepolizumab (MEPO) in Eosinophilic Granulomatosis with Polyangiitis (EGPA) is scarce [1]. Objectives: To assess the efficacy and safety of MEPO in real-life clinical practice. Methods: We retrospectively included patients diagnosed with EGPA and treated with MEPO (100 or 300 mg/month). MEPO efficacy was evaluated in the first 12 months in terms of systemic disease and asthma control. The occurrence of any adverse event (AE) was recorded. Results: 142 patients were included (38% males; median age 46.4 (IQR 36.7-54.4); 110 and 32 on MEPO 100 and 300 mg/month, respectively). General, ear-nose-throat, pulmonary, and neurological symptoms significantly decreased during treatment (table 1). MEPO accounted for a significant reduction in the BVAS (figure 1) and for a steroid sparing effect (figure 2). The proportion of patients with asthma attacks decreased by 90% at 12 months compared to t0, and asthma-related emergency accesses dropped from 17.4% to 2.3%. Overall, 21.1% of patients had a non-serious AE. Table 1. Control of clinical symptoms MEPO beginning (t0 ) 3 months p-value (t3 vs t0 ) 6 months p-value (t6 vs t0 ) 12 months p-value (t12 vs t0 ) N obs N=142 N=135 N=123 N=89 General symptoms 40 (28.2%) 17 (12.6%) &lt;0.001 19 (15.5%) &lt;0.001 13 (14.6%) 0.002 Cutaneous manifestations 13 (9.2%) 6 (4.4%) 0.008 5 (4.1%) 0.025 4 (4.5%) 0.180 ENT manifestations 106 (74.7%) 52 (38.5%) &lt;0.001 44 (35.8%) &lt;0.001 29 (32.6%) &lt;0.001 Pulmonary manifestations 130 (91.6%) 59 (43.7%) &lt;0.001 39 (31.7%) &lt;0.001 28 (31.5%) &lt;0.001 Cardiac manifestations 6 (4.2%) 2 (1.5%) 0.083 2 (1.6%) 0.083 0 0.157 Intestinal manifestations 10 (7.0%) 1 (0.7%) 0.005 4 (3.3%) 0.059 3 (3.4%) 0.059 Renal manifestations 5 (3.5%) 3 (2.2%) 0.414 0 0.046 1 (1.1%) 0.317 Neurological manifestations 36 (25.4%) 22 (16.3%) 0.012 18 (14.6%) 0.003 10 (11.2%) 0.035 Figure 1. Changes in BVAS Figure 2. Steroid treatment Conclusion: MEPO effectively controlled systemic and respiratory EGPA symptoms in a large European cohort, with no major safety concerns. References: [1]Wechsler et al. MEPO or Placebo for Eosinophilic Granulomatosis with Polyangiitis. NEJM. 2017 Disclosure of Interests: Alessandra Bettiol: None declared, Maria Letizia Urban: None declared, Federico Alberici: None declared, Carlo Agostini: None declared, Chiara Baldini: None declared, Enrica Bozzolo: None declared, Paolo Cameli: None declared, Nunzio Crimi: None declared, Stefano Del Giacco: None declared, Allyson Egan: None declared, Georgina Espigol-Frigole Consultant of: Roche and Janssen, Mara Felicetti: None declared, Marco Folci: None declared, Paolo Fraticelli: None declared, Marcello Govoni: None declared, Anna Kernder Grant/research support from: Grant/research support from: GlaxoSmithKline and UCB Pharma for performing the LuLa-study., Carlo Lombardi: None declared, Giuseppe Lopalco: None declared, Claudio Lunardi: None declared, Aladdin J Mohammad Speakers bureau: lecture fees from Roche and Elli Lilly Sweden, PI (GiACTA study), Frank Moosig: None declared, Simone Negrini: None declared, Thomas Neumann: None declared, Pavel Novikov Grant/research support from: This work was supported by the 5-100 Project, Sechenov University, Moscow, Giuseppe Paolazzi: None declared, paola parronchi: None declared, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Vito Racanelli: None declared, Carlo Salvarani: None declared, Maxime Samson: None declared, Jan Schroeder: None declared, Savino Sciascia: None declared, Renato A. Sinico: None declared, Benjamin Terrier: None declared, Paola Toniati: None declared, Domenico Prisco: None declared, Augusto Vaglio: None declared, Giacomo Emmi: None declared