Effects of Reslizumab on Asthma Outcomes in a Subgroup of Eosinophilic Asthma Patients with Self-Reported Chronic Rhinosinusitis with Nasal Polyps

Publication date: Available online 5 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Steven F. Weinstein, Rohit K. Katial, Philip Bardin, Stephanie Korn, Mirna McDonald, Margaret Garin, Eric D. Bateman, Flavia C.L. Hoyte, Matthew Germinaro

ABSTRACT

BACKGROUND

An estimated 7% of patients with asthma have chronic rhinosinusitis with nasal polyps (CRSwNP) and over 80% have at least some radiographic evidence of sinonasal inflammation. Aspirin sensitivity is strongly associated with elevated blood eosinophil levels and increased asthma severity. Intravenous (IV) reslizumab has been shown to improve asthma control in patients with nasal polyps.

OBJECTIVE

These post-hoc analyses of pooled data from two BREATH phase 3 clinical trials, studies 1 and 2 (NCT01287039 and NCT01285323), examined asthma-related outcomes in patients with comorbid, self-reported CRSwNP with and without aspirin sensitivity.

METHODS

Patients aged 12–75 years with elevated blood eosinophils (≥400 cells/μL) and inadequately controlled asthma were randomized to receive placebo or reslizumab (3 mg/kg IV) every 4 weeks for 52 weeks. Patients continued their background asthma maintenance therapy during the study. Information regarding the presence of CRSwNP was obtained through patient-reported medical history.

RESULTS

Add-on reslizumab treatment reduced the frequency of clinical asthma exacerbations (CAE) by 83% vs placebo among patients with CRSwNP. Among patients with and without aspirin sensitivity, reductions of 79% and 84%, respectively, were observed. Patients with CRSwNP (with and without aspirin sensitivity) treated with reslizumab add-on therapy also had significant improvements in lung function, as measured by FEV₁, compared with placebo. Among patients with CRSwNP, reslizumab was also associated with improvements in patient-reported asthma control and asthma quality of life.

CONCLUSION

Patients with eosinophilic asthma and self-reported CRSwNP, with and without aspirin sensitivity, are highly responsive to treatment with reslizumab for asthma-related outcomes. These findings suggest that prospective investigation of reslizumab in this patient population is warranted.