Mepolizumab Brand Name– Nucala
What is Mepolizumab
Mepolizumab is a subcutaneous interleukin (IL)-5 receptor antagonist monoclonal antibody (IgG1, kappa) indicated for add-on maintenance treatment of severe asthma with an eosinophilic phenotype and for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA), which is also known as Churg-Strauss syndrome.
Mepolizumab is directed against IL-5, which is known to play an important role in regulating the function of eosinophils, an inflammatory cell responsible for airway inflammation in some types of asthma and EGPA.
Use of mepolizumab in patients with severe asthma (eosinophilic phenotype) led to fewer exacerbations requiring hospitalization and/or emergency department care and a longer time to the first exacerbation, compared to those who received placebo.
Clinical trial data indicated that mepolizumab use may also lead to a decrease in dosage of oral maintenance corticosteroids, while maintaining asthma control, for these patients.
Mepolizumab treatment did not result in a significant improvement in lung function, as measured by the volume of air exhaled in 1 second (FEV1), in premarketing randomized trials.
Among patients with relapsing or refractory EGPA and taking stable doses of prednisolone or prednisone, mepolizumab use resulted in more time in remission and a lower frequency of relapse compared to placebo, which allowed for a significantly lower glucocorticoid dose in the mepolizumab group.
Indications
- asthma maintenance
- Churg-Strauss syndrome
For asthma maintenance add-on therapy in severe asthma (eosinophilic phenotype)
Side Effects
- abdominal pain
- angioedema
- antibody formation
- asthenia
- back pain
- bronchospasm
- cystitis
- dental pain
- dizziness
- dyspnea
- fatigue
- fever
- flushing
- headache
- hypertension
- hypotension
- infection
- influenza
- injection site reaction
- muscle cramps
- musculoskeletal pain
- myalgia
- nasal congestion
- nausea
- pharyngitis
- pruritus
- rash
- rhinitis
- urticaria
- vomiting
Monitoring Parameters
- pulmonary function tests (PFTs)
Contraindications
- acute bronchospasm
- breast-feeding
- corticosteroid withdrawal
- hamster protein hypersensitivity
- helminth infection
- herpes infection
- pregnancy
- status asthmaticus
Interactions
There are no drug interactions associated with Mepolizumab products.
