Depemokimab reduces exacerbations in patients with severe asthma with eosinophilic phenotype, reveals study

Improperly controlled asthma results
in episodic severe exacerbations despite treatment with medium- or high-dose
inhaled glucocorticoids along with additional controller medications. Increased
levels of high levels of unregulated type 2 inflammation are seen in individuals
with asthma exacerbations. Uncontrolled eosinophilic inflammation is a
recognized risk factor for severe disease exacerbations, airway remodeling, and
decline in lung function among asthmatic patients, with blood reports showing
abnormal eosinophilic counts. Depemokimab is an ultra-long-acting biological
therapy that was shown to be effective in mild to moderate asthma, leading
to dose-dependent suppression of the blood eosinophil count. Hence, researchers
designed replicate trials of phase 3A SWIFT-1 and SWIFT-2 to investigate
the efficacy and safety of Depemokimab as an adjunctive treatment to standard
care for patients who had severe asthma with an eosinophilic phenotype and a
history of exacerbations despite the receipt of medium- or high-dose inhaled
glucocorticoids.

The trial included patients with
severe asthma with an eosinophilic phenotype characterized by a high eosinophil
count. The eosinophilic count was considered high when there were ≥300 cells
per microliter in the previous 12 months or ≥150 cells per microliter at
screening and a history of exacerbations despite receiving medium- or high-dose
inhaled glucocorticoids. Patients were randomly divided in a 2:1 ratio to
receive either Depemokimab (at a dose of 100 mg subcutaneously) or placebo at
weeks 0 and 26, along with standard care. The annualized rate of exacerbations
at 52 weeks was the primary endpoint, while the secondary endpoints included
the change from baseline in the score on the St. George’s Respiratory
Questionnaire (SGRQ), the forced expiratory volume in 1 second, and asthma
symptom reports at 52 weeks.

Findings:

• Among the two trials, 762 were included in the final
  trial, with 502 assigned to receive Depemokimab and 260 assigned to receive a placebo.
• The annualized rate of exacerbations was 0.46
  with Depemokimab, 1.11 with placebo in SWIFT-1, 0.56 with Depemokimab, and 1.08
  with placebo in SWIFT-2.
• The SGRQ score showed no significant
  between-group differences in the change from baseline in either trial. Hence, no
  statistical inference was drawn on subsequent secondary endpoints.
• The adverse events were similar in both groups
  in both trials.

Thus, the researchers concluded
that Depemokimab reduced the annualized rate of exacerbations among patients
with severe asthma with an eosinophilic phenotype as it targeted interleukin-5
or its receptor and improved patient outcomes. Hence, clinicians can consider using
Depemokimab for tailored asthma management in those struggling with
conventional therapies.