Mepolizumab in patients with eosinophilic granulomatosis with polyangiitis in remission: What is the right dose?

Effectiveness and safety of anti-IL-5/Rα biologics in eosinophilic granulomatosis with polyangiitis: a two-year multicenter observational study

“…In addition, 65.3% (32 of 49) of patients were exacerbation-free at 12 months and 61.2% (30 of 49) at 24 months, respectively (Figure 2B). Concerning asthma symptoms, the ACT score increased from 13.5 (10)(11)(12)(13)(14)(15)(16)(17) to 21 (19-23) (p<0.0001) after 3 months, remaining above 20 during follow-ups, indicating good asthma control (p<0.0001 for both biologicals in each time point vs baseline) (Figure 2C). The prebronchodilator FEV 1 % went from 77% (59.3-89.5) to 90.6% (71.5-102.5) after 12 months (p<0.0001) with a slight decline to 81.5% (71.5-100.5) (p<0.0001) at month 24 (Figure 2D).…”

“…Indeed, the phase 3 MIRRA trial (9) proved the superiority of subcutaneous mepolizumab 300 mg every 4 weeks versus placebo in achieving remission and lowering relapses. In addition, several observational studies have shown that even the 100 mg dosage used for severe eosinophilic asthma (38)(39)(40)(41)(42), could be effective (10)(11)(12)(13). This is particularly important as the dosage tested in the registration study is not yet available in several countries.…”

“…Mepolizumab, a humanized monoclonal antibody (mAb) selectively targeting interleukin-5 (IL-5), a cytokine involved in eosinophils maturation, differentiation, recruitment, and survival, has proven to be safe and effective for the treatment of relapsingrefractory EGPA in the phase 3 MIRRA trial at the dosage of 300 mg (9). Nonetheless, real-world studies showed that even 100 mg, currently used for severe eosinophilic asthma, could be effective, particularly for respiratory manifestations (10)(11)(12)(13).…”