Abstract
BACKGROUND: Real-world evidence on the effectiveness of mepolizumab in children and adolescents with severe asthma (SA) is limited. OBJECTIVE: We sought to evaluate mepolizumab's impact on the clinical and health care resource utilization (HCRU) burden of SA in children and adolescents. METHODS: A retrospective study (GSK ID: 218952) was conducted of US administrative claims for patients aged 6-17 years with SA who initiated mepolizumab (from October 1, 2016, to June 30, 2023), had continuous health plan enrollment for ≥12 months pre- and post-mepolizumab initiation, and had ≥1 additional mepolizumab dispensings/administrations ≤6 months from initiation. Rate ratios from Poisson regression models were used to compare asthma exacerbations, oral corticosteroid (OCS) dispensings and bursts, short-acting β(2)-agonist (SABA) canister use, and HCRU per patient-year (PPY) pre- and post-mepolizumab; risk ratios from log-binomial regression models compared proportions of patients with ≥1 OCS dispensings and ≥1 SABA canister dispensings between periods. RESULTS: Of 580 patients, 47% were aged 6-11 years and 53% were aged 12-17 years. Mean OCS dispensings PPY decreased by 24% (P < .001) pre- versus post-mepolizumab initiation. Mean overall asthma exacerbations and OCS bursts PPY decreased by 34% and 29% (P < .001 each), respectively. The proportions of patients with ≥1 OCS dispensings and those using ≥1 SABA canisters decreased by 16% (P < .001) and 3% (P = .039), respectively. Asthma-related HCRU PPY decreased by 23% for inpatient visits (P = .031), 15% for emergency department visits (P = .021), and 26% for outpatient visits (P < .001). CONCLUSIONS: Mepolizumab initiation was associated with significant reductions in asthma exacerbations, OCS and SABA use, and HCRU in children and adolescents with SA, demonstrating real-world clinical benefit.