Indirect treatment comparison (ITC) of mepolizumab and dupilumab in treating COPD

<bold>Background:</bold> Monoclonal antibodies targeting type 2 inflammation, mepolizumab and dupilumab, reduced rates of moderate/severe COPD exacerbations in Phase III randomised controlled trials. <bold>Aims:</bold> Compare mepolizumab data from MATINEE (<ext-link>NCT04133909</ext-link>) vs pooled dupilumab data from BOREAS/NOTUS (<ext-link>NCT03930732</ext-link>/04456673). <bold>Methods:</bold> An ITC was conducted in patients with BEC ≥300 cells/µL, and a subset of MATINEE patients with investigator-assessed symptoms of chronic bronchitis, mMRC score ≥2 and GOLD 1–3 at screening, using matching adjustment for effect modifiers (Figure). Outcomes were annualised rates of moderate/severe and of severe exacerbations, time to first moderate/severe exacerbation, and proportion of SGRQ responders. <bold>Results:</bold> See Figure. There were no significant differences for mepolizumab vs dupilumab in reducing the rate of moderate/severe exacerbations (RR [95% CI]: 0.91 [0.60, 1.37]). Mepolizumab was associated with lower rates of severe exacerbations (RR [95% CI]: 0.68 [0.27, 1.72]) and hazard of first moderate/severe exacerbation (HR [95% CI]: 0.71 [0.46, 1.08]), although with no statistically significant difference. No significant differences in SGRQ responders (OR [95% CI]: 1.19 [0.63, 2.24]). <bold>Conclusions:</bold> The ITC showed no significant difference between mepolizumab and dupilumab in reducing the risk of exacerbations and improving SGRQ in a subset of patients with COPD with similar clinical phenotypes. <bold>Funding:</bold> GSK (223396). <fig><object-id>erj;66/suppl_69/PA488/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>