POS0320 IMPACT OF MEPOLIZUMAB ON PATIENT-REPORTED OUTCOMES IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS BY USING THE ANCA-ASSOCIATED VASCULITIS PATIENT-REPORTED OUTCOMES (AAV-PRO) QUESTIONNAIRE: A EUROPEAN MULTICENTRE PROSPECTIVE STUDY
Authors: P. Delvino, L. Quartuccio, J. C. Robson, F. Alberici, D. Bagnasco, A. Berti, M. Caminati, M. Camoni, M. C. Cid, E. Conticini, G. Costanzo, C. De Moreuil, S. Del Giacco, G. Espigol-Frigole, V. V. Ferretti, F. Franceschini, L. Iorio, A. Kernder, C. Klersy, A. Lo Gullo, L. Losappio, E. Manna, M. Maule, C. Montecucco, S. Negrini, R. Padoan, F. Regola, L. Ricciardi, J. Schroeder, B. Terrier, P. Toniati, E. Treppo, M. L. Urban, A. Vaglio, G. Emmi, S. Monti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Mepolizumab (MEPO) proved its efficacy in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) in the randomised controlled MIRRA trial. The ANCA-associated vasculitis patient-reported outcomes (AAV-PRO) questionnaire is a novel, disease-specific tool, validated with the aim of assessing the impact of the disease and its treatment on the patients' perspectives. <h3>Objectives:</h3> To prospectively evaluate the impact and the rapidity of the effect of MEPO on the AAV-PRO score and patient global assessment (PtGA) in a multicentre cohort of patients with EGPA. <h3>Methods:</h3> Patients with EGPA satisfying the 2022 ACR/EULAR and/or MIRRA trial classification criteria and initiating treatment with MEPO were included. PtGA and AAV-PRO score were prospectively evaluated at MEPO initiation and after 7, 14, 30, 90 and 180 days of treatment. Predictors of improved AAV-PRO response during treatment with MEPO were also investigated. <h3>Results:</h3> Seventy patients were included in the study: female 54.3%, mean age at diagnosis 48.7±12.6 years, 20% ANCA-positive. Sixty-three patients (90%) had a history of relapsing disease. Forty-seven (67.1%) and 23 (32.9%) patients received MEPO 100 mg and 300 mg/4 weeks, respectively, with the main indication being refractory asthma and/or rhinosinusitis. Prednisone (PDN)-equivalent mean dose was 10.8±9.2 mg/day. At MEPO initiation, mean PtGA, AAV-PRO organ-specific symptoms, systemic symptoms, treatment side effects, social and emotional impact, concerns about the future and physical function domain 0-100 score were 59.1±21.2, 30.9±17.8, 25.5±18.6, 18.8±18.1, 32.6±21.9, 37.7±22.1 and 28.2±21.2, respectively. After 7 days, a statistically significant reduction of PtGA [ratio 0.87 (95% CI 0.87—0.95); Table 1] was observed. At 14 days, all AAV-PRO domains, except treatment side effects, showed a statistically significant improvement compared to baseline. Conversely, no relevant amelioration of the AAV-PRO domains was demonstrated between 30 and 180 days of follow-up (Figure 1). Previous history of vasculitic relapse, BVAS ≤3, C-reactive protein ≤5 mg/L and PDN-equivalent dose ≤10 mg/day at MEPO initiation were the main predictors of a better response of the AAV-PRO questionnaire during follow-up. MEPO 300 mg/4 weeks positively influenced organ-specific symptoms compared to MEPO 100 mg/4 weeks, although with a less significant improvement of the treatment side effects domain. Conversely, age, educational level and ANCA status at baseline had no impact on the AAV-PRO domains. <h3>Conclusion:</h3> MEPO allows a quick and remarkable improvement of several aspects of health-related quality of life in patients with refractory EGPA. <b>Table 1.</b> Comparison, at different timepoints, of the AAV-PRO domains 0-100 score, after log-normalization and adjustment for sex and age. <i>OSS: organ-specific symptoms; SS: systemic symptoms; TSA: treatment side effects; SEI: social and emotional impact; CAF: concerns about the future; PF: physical function; PtGA: patient global assessment; 95% CI: 95% confidence interval.</i> <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Paolo Delvino: None declared, Luca Quartuccio: None declared, Joanna C Robson: None declared, Federico Alberici: None declared, Diego Bagnasco: None declared, Alvise Berti: None declared, Marco Caminati: None declared, Marta Camoni: None declared, Maria C. Cid Lecturing fees from GSK, AbbVie, and CSL-Vifor; participation in advisory boards for GSK, CSL-Vifor, AbbVie, and Astrazeneca, Consulting fees from GSK, AbbVie, CSL- Vifor, and AstraZeneca; royalties from UpToDate, Research grant and meeting travel support from Kiniksa Pharmaceuticals Corp, Edoardo Conticini: None declared, Giulia Costanzo: None declared, Claire de Moreuil: None declared, Stefano Del Giacco: None declared, Georgina Espigol-Frigole Speaker fees from VIFOR and GSK, Consulting fees from VIFOR and GSK, Grant research support from GSK, Virginia V. Ferretti: None declared, Franco Franceschini: None declared, Luca Iorio: None declared, Anna Kernder: None declared, Catherine Klersy: None declared, Alberto Lo Gullo: None declared, Laura Losappio: None declared, Elena Manna: None declared, Matteo Maule: None declared, Carlomaurizio Montecucco: None declared, Simone Negrini: None declared, Roberto Padoan: None declared, Francesca Regola: None declared, Luisa Ricciardi: None declared, Jan Schroeder: None declared, Benjamin Terrier: None declared, Paola Toniati: None declared, Elena Treppo: None declared, Maria Letizia Urban: None declared, Augusto Vaglio: None declared, Giacomo Emmi: None declared, Sara Monti: None declared.