Mepolizumab in Eosinophilic Asthma–Striking a Target that was almost Debunked

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Abstract
Pharmacology, Toxicology and Biomedical Reports,2016,2,2,24-26.
Published:May 2016
Type:Review Article

Mepolizumab in Eosinophilic Asthma–Striking a Target that was almost Debunked

Damal Kandadai Sriram1, Govindaraj Gowri2, Melvin George2

1Department of Diabetology and Endocrinology, Hindu Mission Hospital, West Tambaram, Chennai-600045, INDIA.

2Department of Clinical Research, Hindu Mission Hospital, West Tambaram, Chennai-600045, INDIA.

Abstract:

Bronchial asthma continues to be a disease that has high morbidity and a significant proportion of patients remain symptomatic with frequent exacerbations, particularly the eosinophilic variant asthma. Mepolizumab is an anti-interleukin-5 humanized monoclonal antibody that prevents the eosinophilic inflammation in the lungs. The drug was found to reduce the sputum and blood eosinophilic count which was in consonance with its mechanism of action. However earlier clinical trials with the drug proved to be disappointing, due to the lacklustre performance with end points that focussed on the symptoms of the disease and pulmonary function testing. Subsequently trials focussed on selecting patients who had eosinophilic variant asthma with frequent exacerbations who were resistant to even treatment with systemic corticosteroids. The drug was shown to reduce the frequency of exacerbations in pivotal clinical trials besides reducing the dose of steroid requirement. Mepolizumab is to be given via subcutaneous injection once monthly at a dose of 75 to 250 mg. While the drug does meet an unmet need in the population, the long terms effects, most appropriate dose and frequency of usage and its efficacy in other related hypereosinophilic disorders warrants further exploration.