AB0776 REAL-WORLD EVIDENCE ON THE LONG-TERM USE AND DRUG SURVIVAL OF MEPOLIZUMAB IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA)

Background Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of ANCA-associated vasculitis in which it frequently difficult to achieve glucocorticoid (GC) tapering without relapse. Mepolizumab (MEPO) an approved anti-IL5 agent for EGPA but real-world evidence its long-term efficacy and survival scarce. Objectives To study the efficacy, safety, MEPO daily clinical practice. Methods Retrospective all patients who received two academic Rheumatology centers up until January 10, 2023. Demographic data were recorded at baseline (start MEPO) last follow visit. Results 16 treated (females: 87.5%, mean age: 52.4 years, disease duration start: 4.4 ANCA+: 25%) included study. At baseline, median (IQR) BVASv3 was 6 (7) history systemic involvement was: lung 94%, ΕΝΤ musculoskeletal 50%, heart peripheral nervous system 37.5%, skin 25% gastrointestinal 25%. The number relapses before use 2, while 11/16 (69%) had previously failed various immunosuppressive (IS) (MTX, AZA, MMF, CYC) 3/16 (18%) omalizumab treatment. start, on GCs (median prednisolone dose: 12.5 mg/day), 62.5% IS (MMF=6, MTX=2, RTX=2). During follow-up [median (IQR)=12 (19) months], there statistically significant reduction GC dose (median, from 2.5mg/day, p=0.002, (19%) discontinued GCs), absolute eosinophil count (mean, 1603±1163 84±42, p<0.001) 0, p=0.007). cumulative drug 6, 12 18 months 100%, 100% 83% respectively (Figure 1). 2 due relapsing disease, well tolerated withdrawals safety issues. Of note, 3 subjects used concurrently rituximab (RTX) good tolerability. Conclusion In this patients, efficacious safe, high retention rate GC-sparing effects. Furthermore, almost one out five successfully combination RTX. These findings confirm RCT real-life, treat patients. Figure 1. (Kaplan-Meier analysis) real-life Acknowledgements Supported part by Special Account Research Grants (S.A.R.G.), National Kapodistrian University Athens, Greece (DV #12085, 12086). Disclosure Interests None Declared.