Eosinophilic asthma is a rare and often severe form of asthma which can be difficult to treat. Because of this, many patients with eosinophilic asthma experience diminished quality of life (QOL). However, according to Pulmonary Advisor, mepolizumab may soon change the playing field. After conducting a post hoc meta-analysis of data from four Phase 2b/3 clinical trials, researchers determined that mepolizumab was effective in improving patient outcomes and QOL, and reducing symptoms, in patients with eosinophilic asthma and other comorbidities. See the full scope of data published in Respiratory Research.

Mepolizumab

Also known as its brand name, NUCALA, mepolizumab is a fully-humanized monoclonal antibody designed to treat patients over 6 years old with eosinophilic asthma. Mepolizumab also treats eosinophilic granulomatosis with polyangiitis (EGPA).

Within this meta-analysis, researchers sourced data from the Phase 2 DREAM trial, the Phase 3 MENSA trial, the Phase 3 MUSCA trial, and the Phase 3 SIRIUS trial. Altogether, 1,878 patients enrolled within these four trials. Patients were aged 12 or older and had severe eosinophilic asthma. Within the trials, patients received either 75, 250, or 750mg mepolizumab intravenously; 100mg mepolizumab subcutaneously; or a placebo. When broken down, 1,189 received at least one mepolizumab dose while 689 patients received at least one placebo dose.

During the analysis, researchers wanted to understand how mepolizumab impacted those with severe eosinophilic asthma and other comorbidities, such as upper respiratory issues, gastroesophageal reflux disease (GERD), obesity, and diabetes. The study endpoint was the annual rate of asthma exacerbations requiring hospitalizing, corticosteroid use, or ER visits. Ultimately, researchers determined that:

• Altogether, mepolizumab significantly reduced eosinophilic asthma exacerbation by 44-68% as compared to the placebo. Additionally, mepolizumab improved quality of life (QOL), lung function, and overall patient outcome.
• Mepolizumab is a targeted and beneficial treatment for these patients. Overall, it offers a consistent way to manage asthma and related symptoms.

Eosinophilic Asthma

Eosinophilic asthma is considered a severe asthma subtype. Overall, this subtype is characterized by elevated eosinophil levels in the blood, lung tissue, and mucus. Normally, eosinophils, a type of white blood cell, play a role in immune response. Elevated eosinophil levels usually correlate to some sort of infection, inflammation, allergic reaction, or even cancer. But in patients with this asthma subtype, doctors see no known cause for high eosinophil levels. Patients often develop symptoms in adulthood, a contrast to childhood asthma, which normally develops in adolescence. Additionally, many patients with this form do not suffer from allergies. However, this subtype does increase the risk of nasal polyps, airway obstruction, and sinus disease.

Additional symptoms include:

• Shortness of breath
• Difficulty breathing
• Wheezing or coughing
• Chest pressure or tightness
• Airflow obstruction
• Nasal mucous membrane inflammation
• Chronic rhinosinusitis
• Nasal stuffiness
• Reduced sense of small
• Lowered lung function
• Inner ear infections
• Drainage from the ears

Learn more about eosinophilic asthma.