Efficacy of mometasone/indacaterol/glycopyrronium in patients with inadequately controlled asthma with respect to baseline eosinophil count: Post hoc analysis of IRIDIUM study

Background: Baseline characteristics could potentially guide asthma treatments. We evaluated whether baseline eosinophil levels affect the efficacy of mometasone/indacaterol/glycopyrronium (MF/IND/GLY) in patients with inadequately controlled asthma. Method: In this post hoc analysis of IRIDIUM study, efficacy of high-dose MF/IND/GLY (160/150/50 mu g, oncedaily [o.d.]) versus high-dose MF/IND (320/150 mu g o.d.) and high-dose fluticasone/salmeterol (FLU/SAL [500/50 mu g, twice-daily [b.i.d.]); and efficacy of pooled MF/IND/GLY (160/150/50 mu g and 80/150/50 mu g) versus pooled MF/IND (320/150 mu g and 160/150 mu g) was evaluated in patient subgroups with baseline blood eosinophil count of <300 cells/mu L or >= 300 cells/mu L. Results: Overall, 3065 patients were included. At Week 26, high-dose MF/IND/GLY showed improved trough FEV1 versus high-dose MF/IND (.78mL [<300 cells/mu L];Delta 54mL [>= 300 cells/mu L]) and FLU/SAL (Delta 112mL [<300 cells/mu L];Delta 98mL [>= 300 cells/mu L]). Similarly, pooled MF/IND/GLY also showed improved trough FEV1 versus pooled MF/IND (Delta 75mL [<300 cells/mu L];.68mL [>= 300 cells/mu L]). Over 52 weeks, high-dose MF/IND/GLY reduced the annualized rate of moderate or severe asthma exacerbations by 23% and 10%, severe exacerbations by 31% and 15%, and all exacerbation by 33% and 10% versus high-dose MF/IND for subgroups with <300 cells/mu L and >= 300 cells/mu L, respectively; and by 33% and 41%, 45% and 42%, 42% and 39% versus FLU/SAL, respectively. Similarly, pooled MF/IND/GLY reduced exacerbations by 22% and 8%, 21% and 7%, 27% and 8%, versus pooled MF/IND, for the respective subgroups. Conclusion: MF/IND/GLY showed improvement in lung function and reduction in asthma exacerbations over MF/ IND and FLU/SAL independent of baseline eosinophil levels, indicating that eosinophil levels did not affect the efficacy of MF/IND/GLY in patients with inadequately controlled asthma.