Cumulative Corticosteroid Sparing Effect of Anti-Interleukin-5/5Ra In Eosinophilic Asthma

Anti-interleukin-5/5Ra therapy has shown to reduce maintenance oral corticosteroid dose in severe eosinophilic asthma. However, the effect on cumulative oral corticosteroid exposure is currently unknown. Neither is it known how prior oral corticosteroid exposure affects response to anti-interleukin-5/5Ra treatment. We aimed primarily to compare the cumulative oral corticosteroid exposure over a 2-year period before and after anti-interleukin-5/5Ra initiation, and secondarily to investigate whether duration and cumulative oral corticosteroid exposure prior to anti-interleukin-5/5Ra influence the ability to discontinue oral corticosteroids within 2 years of anti-interleukin-5/5Ra therapy. This real-world nationwide observational registry-based study evaluated all dispensed oral corticosteroids from 389 adults with severe eosinophilic asthma included in the Dutch severe asthma registry (RAPSODI) 2 years before and 2 years after initiating anti- interleukin-5/5Ra. Wilcoxon-signed rank test and multivariable regression analyses were used. Median (IQR) cumulative oral corticosteroid exposure in the 2 years before and after anti-interleukin-5/5Ra initiation decreased from 2.715 g (1.150-5.539) to 1.050 g (0.300-3.640), p