Evaluating the effectiveness and safety of mepolizumab in elderly patients with severe asthma: insights from the REDES study

Objective: Asthma and severe asthma are problems affecting all age groups, but asthma is frequently undiagnosed in the elderly, due to the poor perception of airflow limitation, lack of fitness, and presence of multiple comorbidities. Even so, the proportion of patients with severe asthma aged >= 65 is significant, and data on efficacy of asthma medications in the elderly are sometimes limited. We report here the effectiveness and safety of mepolizumab (an IL-5 inhibitor) in elderly (>= 65 years) patients. Methods: The REDES study was an observational, multicenter study of the effectiveness and safety of mepolizumab 100 mg SC every 4 weeks in 318 severe asthma patients in Spain. This post-hoc analysis compares the effectiveness and safety of patients >= 65 years old to patients <65 years after 12 months of mepolizumab treatment. Results: 27% of patients were >= 65 years old, compared with 73% of patients <65 years. Elderly patients showed a trend toward less frequent comorbid nasal polyps (p = 0.06) and a lower proportion of atopic sensitization (as detected by prick test or specific IgE) (p = 0.02). Similar improvements were noted in ACT score (p < 0.0001), comparable exacerbation reductions (p < 0.0001), and lung function parameters (p < 0.04 in elder group and p < 0.0001 in younger elder group), although an apparent greater reduction of OCS daily dose was observed in elder patients (p = 0.0002). No new safety signals were reported in the elderly population. Conclusions: This study further supports mepolizumab as an effective and well tolerated therapy in the difficult to treat population of elderly patients with severe asthma.