Monica Kraft, MD, prepared a useful Practice Aid pertaining to uncontrolled asthma for this CME activity titled "The Latest Evidence on Treatment for Uncontrolled Persistent Asthma: Breaking News From Dallas." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2XnuYrB. CME credit will be available until July 4, 2020.

1. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Key Findings in Uncontrolled Persistent Asthma:
Insights From ATS 2019
ACQ: Asthma Control Questionnaire; AQLQ: Asthma Quality of Life Questionnaire; AQLQ(S)+12: Asthma Quality of Life Questionnaire (standardized) for patients 12 years and older; ATS: American Thoracic Society; FeNO: fractional exhaled nitric oxide; LMK-CT: Lund-Mackay CT;
NPIF: nasal peak inspiratory flow; NPS: Nasal Polyp Score; OCS: oral corticosteroid; SGRQ: St. George's Respiratory Questionnaire; SNOT: Sino-Nasal Outcome Test.
1. Alberts FC et al. American Thoracic Society 2019 International Conference (ATS 2019). Abstract A1274. 2. Ackert JL et al. ATS 2019. Abstract A2674. 3. Kavanagh J et al. ATS 2019. Abstract A2675. 4. Fitzgerald JM et al. ATS 2019. Abstract A2676. 5. Wechsler M et al. ATS 2019.
Abstract A1271. 6. Ford LB et al. ATS 2019. Abstract A2666. 7. Hanania N et al. ATS 2019. Abstract A2667. 8. Laidlaw T et al. ATS 2019. Abstract A7356. 9. Corren J et al. ATS 2019. Abstract A2622. 10. Corren J et al. ATS 2019. Abstract A2621.
PRACTICE AID
Access the activity, “The Latest Evidence on Treatment for Uncontrolled Persistent Asthma:
Breaking News From Dallas,” at PeerView.com/GSV40.
Mepolizumab
Meta-analysis, MUSCA and MENSA1
• In both age-at-onset categories (40, ≥40), mepolizumab significantly reduced clinically significant
exacerbations vs placebo
• Improvement in lung function, SGRQ, and ACQ-5 greater for mepolizumab than placebo in both age-at-onset
categories
Meta-analysis, MUSCA and MENSA2
• Among patients with uncontrolled asthma at baseline, 25% of patients on mepolizumab achieved complete
control vs 12% on placebo; 49% on mepolizumab vs 30% on placebo achieved partial or complete asthma control
at the end of treatment (12 weeks)
Benralizumab
Retrospective analysis of 15 patients with
OCS-dependent severe eosinophilic asthma
who were switched to benralizumab after a
suboptimal response to mepolizumab3
• Median OCS dose on final injection of mepolizumab was 10 mg compared to 7.5 mg after 16 weeks of benralizumab
• No significant improvement in ACQ-6 but significant improvement in AQLQ
• No significant changes in FeNO or post-bronchodilator FEV1
2-year integrated efficacy and safety
analysis4
• Reductions in exacerbation frequency observed during SIROCCO/CALIMA trials were maintained, as were
improvements in pre-bronchodilator FEV1
, ACQ-6, and AQLQ(S)+12
• Rates of adverse events were similar between the BORA extension and SIROCCO/CALIMA and ZONDA trial groups
Reslizumab
Post-hoc analysis of two phase 3 trials5
• 61% of patients on reslizumab had no exacerbations vs 30% of patients on placebo
• Reslizumab significantly increased the time to first exacerbation (18 weeks vs 4.6 weeks for placebo)
• Higher proportion of patients on reslizumab had improvement in lung function, systemic corticosteroid use,
ACQ-6, and AQLQ

2. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Key Findings in Uncontrolled Persistent Asthma:
Insights From ATS 2019
ACQ: Asthma Control Questionnaire; AQLQ: Asthma Quality of Life Questionnaire; AQLQ(S)+12: Asthma Quality of Life Questionnaire (standardized) for patients 12 years and older; ATS: American Thoracic Society; FeNO: fractional exhaled nitric oxide; LMK-CT: Lund-Mackay CT;
NPIF: nasal peak inspiratory flow; NPS: Nasal Polyp Score; OCS: oral corticosteroid; SGRQ: St. George's Respiratory Questionnaire; SNOT: Sino-Nasal Outcome Test.
1. Alberts FC et al. American Thoracic Society 2019 International Conference (ATS 2019). Abstract A1274. 2. Ackert JL et al. ATS 2019. Abstract A2674. 3. Kavanagh J et al. ATS 2019. Abstract A2675. 4. Fitzgerald JM et al. ATS 2019. Abstract A2676. 5. Wechsler M et al. ATS 2019.
Abstract A1271. 6. Ford LB et al. ATS 2019. Abstract A2666. 7. Hanania N et al. ATS 2019. Abstract A2667. 8. Laidlaw T et al. ATS 2019. Abstract A7356. 9. Corren J et al. ATS 2019. Abstract A2622. 10. Corren J et al. ATS 2019. Abstract A2621.
PRACTICE AID
Access the activity, “The Latest Evidence on Treatment for Uncontrolled Persistent Asthma:
Breaking News From Dallas,” at PeerView.com/GSV40.
Dupilumab
Prespecified analysis from phase 3
LIBERTY ASTHMA VENTURE6
• Patients taking dupilumab had clinically significant change in ACQ, as well as improvement in AQLQ by week 12
• Adverse events included eosinophilia (14% dupilumab vs 1% placebo) and injection-site reactions (9% vs 4%)
Post-hoc analysis of LIBERTY
ASTHMA QUEST7
• Dupilumab significantly reduced the annualized rate of severe exacerbations in patients with late-onset asthma
and fixed airway obstruction (-68.8% and -75.7%, respectively) and in patients without fixed airway obstruction
(-55.1% and -50.7%, respectively)
• Lung function improved in patients with late-onset asthma and fixed airway obstruction (P .05 vs placebo)
• Late-onset asthma patients without fixed airway obstruction had more modest improvements vs placebo in
pre-bronchodilator FEV1
at weeks 12 and 52 than did those with fixed airway obstruction
Post-hoc analysis of SINUS-24 and
SINUS-52 studies8
Patients taking dupilumab experienced significant improvements vs placebo in:
• FEV1
• ACQ-6
• SNOT-22
• NPIF
• Endoscopic NPS
• Patient-reported nasal congestion
• Sinus LMK-CT
Tezepelumab
Phase 2 PATHWAY9,10
• Compared with placebo, reductions in asthma exacerbations requiring hospitalization were observed in all
tezepelumab groups
• Rates of all-cause hospital visits and all-cause ED visits were also reduced for patients taking tezepelumab
• Reductions in annualized rate of exacerbations were observed at week 52 irrespective of baseline biomarkers