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Updated: May 18, 2026
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Mepolizumab treatment for asthma
1Imperial College London, Leukocyte Biology, Sir Alexander Fleming Building, London, SW7 2AZ, UK. d.s.robinson@imperial.ac.uk
Expert Opinion on Biological Therapy
|September 25, 2012
Summary
Mepolizumab significantly reduces exacerbations in severe asthma patients with eosinophilic airway inflammation. This targeted biologic therapy offers a new option for those uncontrolled by inhaled (ICS) or oral corticosteroids (OCS).
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Severe asthma affects 5% of asthmatics, characterized by high morbidity and healthcare costs.
- A subset of severe asthmatics (20-40%) exhibits persistent airway eosinophilia and frequent exacerbations.
- Mepolizumab targets interleukin-5 (IL-5), a key cytokine in eosinophil development.
Purpose of the Study:
- To evaluate the efficacy of mepolizumab in severe asthma patients.
- To assess the impact of mepolizumab on eosinophil counts and exacerbation rates.
Main Methods:
- Review of pharmacology and clinical studies (Phase I/IIa, II/III) of mepolizumab in asthma.
- Analysis of mepolizumab's effect on blood, sputum, and bone marrow eosinophils.
- Evaluation of exacerbation rates in unselected and eosinophil-selected asthma cohorts.
Main Results:
- Mepolizumab depleted eosinophils in blood and sputum and reduced airway remodeling.
- No significant lung function improvement in unselected patients, but a trend toward fewer exacerbations.
- A 50% reduction in exacerbations was observed in patients selected for persistent sputum eosinophilia.
Conclusions:
- Mepolizumab effectively reduces exacerbations in severe asthma with eosinophilic inflammation despite corticosteroid treatment.
- This represents a novel therapeutic option for approximately 30% of severe asthmatics.
- Further research is needed to confirm efficacy, expand indications, and explore remodeling effects.
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