Background and importance Mepolizumab and benralizumab are two biological drugs used in severe uncontrolled asthma (SUA) patients. There is a lack of data in actual clinical practice regarding the relationship of effectiveness and adherence.
Aim and objectives The aim of this study was to describe the treatment adherence of mepolizumab and benralizumab in SUA patients and to assess the relationship between this adherence and effectiveness.
Material and methods Retrospective observational study developed in the Outpatient Pharmaceutical Care Unit of a tertiary university hospital. All patients diagnosed with SUA who were under treatment with mepolizumab and benralizumab were included during the period January 2017–March 2021.
Data collected: demographic; pharmacological: drug (mepolizumab/benralizumab), duration of treatment (DOT), concomitant administration of oral corticosteroids (OC); phenotype (eosinophilic/allergic/other).
Non-adherence was evaluated by reviewing all scheduled drug dispensing visits in the computerised application. This fact was considered every time that a patient collected medication later than scheduled according to frequency of administration (28 days for mepolizumab and 56 days for benralizumab), by which dispensation missed (DM) was defined.
The number of DM was identified for mepolizumab (DM-mepolizumab) and benralizumab (DM-benralizumab).
Effectiveness was defined by evaluating at baseline/3/6/12 months: the Asthma Control Test (ACT) parameter, forced expiratory volume in the first second (FEV1) and need for OC.
Results are presented as median (standard deviation) for quantitative variables and number (percentage) for qualitative variables.
Results Thirty-four patients were included: age 59 (12) years, women 21 (55.3%), obese 10 (26.3%), Caucasian 31 (81.6%).
Results were: mepolizumab 22 (57.9%) and benralizumab 16 (42.1%), both drugs were used sequentially in 4 patients (11.8%). Naïve 22 (57.9%), DOT 20.0 (11.7) months, concomitant OC 15 (39.5%); eosinophilic phenotype 26 (68.4%), allergic 5 (14.7%), others 7 (18.4%).
A total of 622 dispensations were identified: mepolizumab 505 (76.5%) and benralizumab 155 (23.5%).
DM 30 (4.8%) were distributed as DM-mepolizumab 27/30 (90%) versus DM-benralizumab 3/30 (76.5%).
Effectiveness (baseline/3/6/12 months) was shown to be: ACT 12/20/17/17, the FEV1 of 58%/76%/72%/83% and the number of patients with OC of 15/17/16/9.
Conclusion and relevance Mepolizumab or benralizumab were collected later than expected in less than 5% of scheduled dispensations. Thus a high grade of adherence to these drugs could be considered.
More adherence to the biological drug was related to higher effectiveness according to the values of ACT, FEV1 and use of OC for the first year of treatment.
Conflict of interest No conflict of interest
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