Mepolizumab for difficult-to-control asthma with persistent sputum eosinophilia.

BACKGROUND: In asthma, anti-inflammatory therapy can usually reduce airway eosinophilic inflammation; but in certain subgroups this persists despite maximal therapy, and disease control is suboptimal. Mepolizumab is an anti IL-5. antibody that might reduce airway inflammation in such subgroups.

METHODS AND RESULTS: Evaluation of the efficacy and safety data on mepolizumab in two studies performed in patients with refractory and corticosteroid-dependent asthma with persistent sputum eosinophilia. Mepolizumab given intravenously once a month was able to reduce sputum/blood eosinophilia and asthma exacerbations and to improve quality of life.

CONCLUSIONS: Mepolizumab may be a promising anti-inflammatory therapy in asthma subgroups with heavy eosinophilic load in which conventional anti-inflammatory therapy is only partially effective.