This study demonstrated the long-term efficacy of mepolizumab, a monoclonal interleukin-5 antibody, in reducing asthma exacerbations, steroid dependence, and nasal polyps over a 3-year period.
Mepolizumab (MEP) is a monoclonal antibody that acts against interleukin (IL)-5 to control the proliferation, maturation, and activity of eosinophils. The efficacy of MEP in patients with severe asthma has been demonstrated in the literature. However, evidence related to the long-term safety and efficacy of the drug is limited.
This prospective observational study aimed to investigate the effect of MEP on steroid dependence, asthma exacerbation, and nasal polyps in patients with severe asthma. The study’s findings are published in the journal Biomedicines.
The study included a total of 157 patients, of whom, 80 were male. The mean age of participants was 59 (range 21–84) years. Of the total patients, 99 had chronic rhinosinusitis with nasal polyps (CRSwNP), with a sino-nasal outcome test (SNOT-22) score of 51 ± 15.
Mepolizumab and Asthma Exacerbations
The exacerbations decreased from 3.9 ± 2.8 to 0.6 ± 1.2 per year following treatment with MEP during the first year. The exacerbations were further reduced during the second and third years, suggesting that the efficacy of MEP was maintained in this group of patients with severe asthma.
Mepolizumab and Oral Corticosteroid Dependence
Oral corticosteroid (OCS) dependence was 54% at baseline, which reduced to 21% in the first year of MEP treatment. OCS dependence was further reduced to 11% and 6% in the second and third years, respectively. Approximately 87% of OCS-dependent patients reported complete discontinuation of OCS over a period of 3 years. Lung function, as indicated by an increase in forced expiratory volume (FEV1), also improved.
Mepolizumab and Asthma Control
Asthma Control Test (ACT) scores significantly increased during the first year; however, the ACT scores plateaued for the remaining years. The reduction of SNOT-22 scores from baseline also indicated improved control of nasal symptoms in the study participants. Approximately 26% of patients discontinued treatment due to drug inefficacy, inefficacy in nasal symptoms, and frequent exacerbations of CRSwNP.
Moore, M. Z., Perez, C. A., Hutton, G. J., Patel, H., & Cuascut, F. X. (2023). Health Disparities in Multiple Sclerosis among Hispanic and Black Populations in the United States. Biomedicines, 11(4), 1227. https://doi.org/10.3390/biomedicines11041227