POS0836 EFFICACY OF MEPOLIZUMAB IN PATIENTS WITH EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS AND A VASCULITIC PHENOTYPE

Background Patients with eosinophilic granulomatosis polyangiitis (EGPA) can present vasculitic or phenotypes. 1 The Phase III MIRRA study demonstrated that patients EGPA spent more time in remission and had reduced oral corticosteroid (OCS) use mepolizumab versus placebo. 2 Objectives To evaluate the efficacy of a phenotype enrolled study. Methods was III, multicentre, double-blind, parallel-group trial adult relapsing/refractory ≥4 weeks stable OCS treatment. were randomised to receive standard care plus (300 mg subcutaneously every 4 weeks) placebo for 52 weeks. Primary endpoints were: accrued (defined as Birmingham Vasculitis Activity Score [BVAS] 0 dose ≤4 mg/day prednisolone equivalent) over 52-week period categorised (0, >0 <12, 12 <24, 24 <36 ≥36 weeks), proportion at both Weeks 36 48. This post hoc analysis used data from these according patients’ antineutrophil cytoplasmic antibody (ANCA) history (current previous positive test myeloperoxidase[MPO]/proteinase 3[PR3]-ANCA baseline no MPO/PR3-ANCA baseline), BVAS (=0 vs >0) Damage Index (VDI) score (<5 ≥5). Types disease relapse (vasculitis [BVAS >0], asthma [active symptoms and/or signs worsening Asthma Control Questionnaire-6 score] sinonasal nasal sinus ≥1 symptom questions]) reported during treatment also described. characteristics focusing on components assessed who did not achieve any point Results Of 136 study, 26 (19%) ANCA 110 (81%) not. In addition, 51 (38%) =0 while 85 (63%) >0; 74 (54%) VDI <5 62 (46%) ≥5. Accrued duration greater placebo, irrespective status, (Figure 1). Across all subgroups, larger achieved 48 Among receiving mepolizumab, numbers (proportion) achieving 7 an ANCA-positive 15 (27%) without test; 14 (45%) 8 (22%) groups; 11 (29%) (37%) ≥5 groups. Mepolizumab types period, including vasculitis, relapses, compared Vasculitic neuropathy, glomerulonephritis, alveolar haemorrhage, palpable purpura positivity generally similar among Figure 1. by patient ANCA, antibody; BVAS, Score; CI, confidence interval; NA, available – estimate could be calculated owing lack group 48; VDI, Index. Conclusion is associated clinical benefits EGPA, those phenotype. References [1]Latorre M et al. Eur Respir J. 2013;42(Suppl 57):1797. [2]Wechsler ME N Engl J Med . 2017;376(20):1921–32. Acknowledgements Funding: GSK (MEA115921; NCT02020889 ); Division Intramural Research, NIAID, NIH funded part this abstract one authors (PK). Disclosure Interests Benjamin Terrier Consultant of: Roche, Chugai, GSK, AstraZeneca, Bristol Myers Squibb, Terumo BCT, Sanofi, LFB Grifols, David Jayne Speakers bureau: Amgen Vifor, Aurinia, BMS, Boehringer Ingelheim, ChemoCentryx, Janssen, Novartis, Roche/Genentech, Takeda Grant/research support from: Bernhard Hellmich AbbVie, InflaRx, Pfizer, Roche Vifor Pharma, Ab2Bio, Kiniksa, Nippon Kayaku, Sanofi (my institution received payments participation multicentre trials myself money other kind research projects), Jane H. Bentley Shareholder Employee Jonathan Steinfeld Steven W Yancey Namhee Kwon Praveen Akuthota Paid instructor for: AstraZeneca Regeneron, Paneez Khoury: None declared, Lee Baylis Michael Wechsler Genentech, Teva, Sentien, Equillium, National Institute Allergy Infectious Diseases Heart, Lung, Blood