Profile of anti-IL-5 mAb mepolizumab in the treatment of severe refractory asthma and hypereosinophilic diseases

Figures & data

Table 1 Efficacy and safety of mepolizumab in asthma and other eosinophilic diseases

Disease	Efficacy	Safety profile
Asthma	Mepolizumab reduces peripheral blood eosinophilia, percentage of bone marrow eosinophils, airway eosinophils, and rate of exacerbations in almost all RCTs. Improvements in FEV1 were found in only two studies^Citation13,Citation36	No relevant AE
HES	Primary end points achieved	No relevant AE
EGBPA	Primary end points achieved	No relevant AE
Eosinophilic esophagitis	Primary end points not achieved	No relevant AE
Nasal polyposis	Primary end points achieved	No relevant AE
Atopic dermatitis	Primary end points not achieved	No relevant AE
COPD	Ongoing RCTs	No data available at the time

Abbreviations: HES, hypereosinophilic syndrome; EGBPA, eosinophilic granulomatosis with polyangiitis; AE, adverse event; RCTs, randomized clinical trials; FEV1, forced expiratory volume in 1 second.

Figure 1 Interaction between Th2 lymphocytes and eosinophils, and molecular structure of mepolizumab with its therapeutic target.

Abbreviation: IL, interleukin.

Table 2 Main studies and results for mepolizumab in asthma

Year	Study	FEV1 increase	Acute exacerbations reduction	Blood eosinophils count reduction	Sputum eosinophils count reduction	Decrease in prednisone use	AQLQ	ACQ	Reduction in airway inflammation	Comments
2003	Flood-Page et al^Citation47	NS	NA	S	NA	NA	NA	NA	S
2007	Flood-Page et al^Citation35	NA	NS	S	NA	NA	NA	NA	NA	Data not statistically significant due to incorrect selection of sample
2009	Haldar et al^Citation36	NS	S	S	S	NA	S	NA	NS	61 subjects with eosinophilic asthma and recurrent exacerbation
2009	Nair et al^Citation37	S	S	S	S	S	NA	NA	NA	20 subjects with persistent sputum eosinophilia and symptoms despite prednisone treatment
2012	Pavord et al^Citation38	NS	S	S	S	NA	NS	NS	NA	621 patients with recurrent severe asthma exacerbations and signs of eosinophilic inflammation
2014	Ortega et al^Citation51	S	S	NA	NA	NA	NA	S	NA	576 patients with recurrent asthma exacerbations and eosinophilic inflammations

Abbreviations: NA, not applicable; NS, not significant; S, significant; FEV1, forced expiratory volume in 1 second; AQLQ; Asthma Quality of Life Questionnaire; ACQ, Asthma Control Questionnaire.

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