{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:03:44Z","timestamp":1792533824046,"version":"4.5.0"},"reference-count":28,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","award":["GSK study ID: 201810\/NCT02555371"],"award-info":[{"award-number":["GSK study ID: 201810\/NCT02555371"]}],"id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2021,5,23]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The long-term efficacy and safety of mepolizumab for treatment of severe eosinophilic asthma are well established. Here, we examine the clinical impact of stopping mepolizumab after long-term use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      COMET (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02555371\">NCT02555371<\/jats:ext-link>\n                      ) was a randomised, double-blind, placebo-controlled, parallel-group, multicentre study. Patients who had completed COLUMBA (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01691859\">NCT01691859<\/jats:ext-link>\n                      ) or COSMEX (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02135692\">NCT02135692<\/jats:ext-link>\n                      ) and received continuous mepolizumab treatment for \u22653\u2005years were randomised 1:1 to stop (switch to placebo) or continue subcutaneous mepolizumab 100\u2005mg every 4\u2005weeks for 52\u2005weeks. Primary end-point: time to first clinically significant exacerbation; secondary end-points: time to first exacerbation requiring hospitalisation\/emergency department visit, time to decrease in asthma control (\u22650.5-point increase in Asthma Control Questionnaire-5 score from COMET baseline) and blood eosinophil count ratio to COMET baseline. Safety was assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients stopping (n=151)\n                      <jats:italic>versus<\/jats:italic>\n                      continuing (n=144) mepolizumab had significantly shorter times to first clinically significant exacerbation (hazard ratio 1.61, 95% CI 1.17\u20132.22; p=0.004) and decrease in asthma control (hazard ratio 1.52, 95% CI 1.13\u20132.02; p=0.005), and higher blood eosinophil counts at week 52 (270\n                      <jats:italic>versus<\/jats:italic>\n                      40\u2005cells\u00b7\u00b5L\n                      <jats:sup>\u22121<\/jats:sup>\n                      ; ratio (stopping\n                      <jats:italic>versus<\/jats:italic>\n                      continuing) 6.19, 95% CI 4.89\u20137.83; p&lt;0.001). Differences in efficacy outcomes between groups were observed when assessed from week 12 (16\u2005weeks after last mepolizumab dose). Exacerbations requiring hospitalisation\/emergency department visit were rare. Adverse events in patients continuing mepolizumab were consistent with previous studies. For patients who stopped mepolizumab, the safety profile was consistent with other eosinophilic asthma populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Patients who stopped mepolizumab had an increase in exacerbations and reduced asthma control\n                      <jats:italic>versus<\/jats:italic>\n                      those who continued.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.00396-2021","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T12:05:24Z","timestamp":1624622724000},"page":"2100396","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":117,"title":["Stopping\n                    <i>versus<\/i>\n                    continuing long-term mepolizumab treatment in severe eosinophilic asthma (COMET study)"],"prefix":"10.1183","volume":"59","author":[{"given":"Wendy C.","family":"Moore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kornmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0703-2892","authenticated-orcid":false,"given":"Marc","family":"Humbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude","family":"Poirier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth H.","family":"Bel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1243-2487","authenticated-orcid":false,"given":"Norihiro","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyn J.","family":"Gilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6418-6818","authenticated-orcid":false,"given":"Robert G.","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Bradford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C.","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"key":"2024102102350704000_59.1.2100396.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60988-X"},{"key":"2024102102350704000_59.1.2100396.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808991"},{"key":"2024102102350704000_59.1.2100396.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1403291"},{"key":"2024102102350704000_59.1.2100396.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1403290"},{"key":"2024102102350704000_59.1.2100396.5","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/S2213-2600(17)30125-X","article-title":"Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial","volume":"5","author":"Chupp","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2024102102350704000_59.1.2100396.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2016.07.010"},{"key":"2024102102350704000_59.1.2100396.7","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1016\/j.jaci.2018.09.033","article-title":"Assessment of the long-term safety of mepolizumab and durability of clinical response in patients with severe eosinophilic asthma","volume":"143","author":"Khatri","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"2024102102350704000_59.1.2100396.8","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/j.clinthera.2019.07.007","article-title":"Long-term safety and clinical benefit of mepolizumab in patients with the most severe eosinophilic asthma: the COSMEX study","volume":"41","author":"Khurana","year":"2019","journal-title":"Clin Ther"},{"key":"2024102102350704000_59.1.2100396.9","unstructured":"United States Food and Drug Admininstration . 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