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.