Mepolizumab and benralizumab significantly improve lung function and minimize or prevent exacerbations and oral corticosteroid use.
Asthma is a chronic, heterogeneous inflammatory disease of the lungs caused by different cells and inflammatory mediators and largely defined by genetics, that causes bronchial hyperreactivity and airflow limitation, resulting in recurrent wheezing, dyspnea, and exacerbations. It is a common, non-contagious condition in children and adults. According to the WHO, more than 262 million people worldwide had asthma in 2019, and 461,000 died from a lack of diagnosis and treatment.
Mepolizumab and benralizumab are humanized monoclonal antibodies that selectively and effectively suppress the eosinophilic cascade by inhibiting interleukin (IL)-5 and its receptor (IL-5R).
A retrospective observational cohort study published in International Journal of Molecular Sciences found that the number of exacerbations, the use of oral corticosteroids, and blood eosinophil levels decreased significantly in individuals treated with the anti-I-L5 therapies mepolizumab and benralizumab.
Severe Uncontrolled Asthma Reduces Quality of Life
Severe uncontrolled asthma (SUA) accounts for almost 25% of severe asthma patients. High doses of oral corticosteroids, exacerbations, and impaired lung function are the primary factors reducing the quality of life of these individuals.
Mepolizumab Treatment Is Highly Effective for Severe Uncontrolled Asthma
In patients with SUA, mepolizumab treatment was highly effective in reducing the number of oral corticosteroid (OCS) bursts needed per year, maintenance OCS, blood eosinophil levels, IgE, and the annual risk of exacerbations requiring emergency department treatment and/or hospitalization. As measured by the Asthma Control Test (ACT) questionnaire and forced expiratory volume (FEV)1 score, a considerable improvement in asthma control was observed. After 12 months of treatment with mepolizumab, in 47.2% (42/89) of instances, the rate of exacerbations was reduced by at least 50%, and 41.6% (37/89) did not experience an exacerbation throughout the follow-up period.
Benralizumab Works Well for Severe Uncontrolled Asthma
After using benralizumab for 12 months, there were significant reductions in OCS bursts needed per year, blood eosinophils, and the number of exacerbations needing emergency care or hospitalization. Moreover, both lung function and ACT score improved significantly. In 42.1% (24/57) of the patients, the rate of exacerbations decreased by at least 50%, and 52.6% did not experience an exacerbation requiring emergency department care and/or hospitalization.
Significant Improvement Observed in Pulmonary Function After Biological Therapy
After 12 months of biological therapy with mepolizumab or with benralizumab, pulmonary function improved significantly. Mean FEV1 increased by 10.3% with mepolizumab and 11.4% with benralizumab. In contrast, neither of the two biological therapies demonstrated statistically significant changes in patients with FEV1 values exceeding 80%.
It is concluded that mepolizumab and benralizumab considerably improve lung function and reduce or prevent exacerbations and the usage of oral corticosteroids. Furthermore, biological treatments have substantially impacted the quality of life and healthcare burden of persons with SUA.
Rojo-Tolosa, S., González-Gutiérrez, M. V., Jiménez-Gálvez, G., Sánchez-Martínez, J. A., Pineda-Lancheros, L. E., Gálvez-Navas, J. M., Jiménez-Morales, A., et al. (2023). Impact of Anti-IL5 Therapies on Patients with Severe Uncontrolled Asthma and Possible Predictive Biomarkers of Response: A Real-Life Study. International Journal of Molecular Sciences, 24(3), 2011. MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijms24032011