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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Respiratory Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1449220
This article is part of the Research Topic Therapeutic Advances in Lung Cancer and Chronic Inflammatory Lung Disease View all 10 articles

Long-term effects of mepolizumab in patients with severe eosinophilic asthma: a 6-year real-life experience

Provisionally accepted
Anna A. Stanziola Anna A. Stanziola 1Claudio Candia Claudio Candia 1Gerardo Nazzaro Gerardo Nazzaro 1Antonio Caso Antonio Caso 1Claudia Merola Claudia Merola 2Lorena Gallotti Lorena Gallotti 3Mauro Maniscalco Mauro Maniscalco 1,2*
  • 1 University of Naples Federico II, Naples, Campania, Italy
  • 2 IRCCS Fondazione Salvatore Maugeri, Pavia, Lombardy, Italy
  • 3 Federico II University Hospital, Naples, Campania, Italy

The final, formatted version of the article will be published soon.

    Background. Severe eosinophilic asthma (SEA) is often linked to a dysregulation in the Interleukin-(IL)-5 axis. Mepolizumab, a humanized monoclonal antibody, reduces eosinophils by directly binging to IL-5, potentially restoring homeostatic eosinophil biology, with a significant impact on quality of life, acute exacerbations and oral corticosteroids (OCS) elimination in SEA patients. While its shortand middle-term effects are well described, no study has so far investigated its long-lasting effects in SEA patients. The aim of our study was therefore to explore the effects of a long-term, six-year continuous treatment with mepolizumab on clinical control and clinical remission in a cohort of SEA patients.Methods. We conducted a retrospective review of clinical records of patients who were prescribed mepolizumab between June 2017 and April 2018. We collected demographical, functional, and clinical data from visits performed at baseline and then at the specified timepoints and checked if patients had reached clinical remission after 6 years. We assessed asthma control test (ACT), exacerbation rate, and OCS elimination dose at six years. Clinical Remission (CR) was defined on the basis of the elimination of OCS and the contemporary presence of all the following: (1) stable lung function; (2) no exacerbation in the previous 12 months; (3) acceptable symptom control (ACT ≥ 20).Of 86 patients screened, 62 were included in the final analysis. Our study suggests that mepolizumab is effective and well tolerated after a six-year course of continuous treatment in patients with SEA. We reported a prevalence of 28 (46.8%) patients who reached complete CR at 72 months from the treatment start. 75% of patients eliminated the maintenance OCS already after one year of treatment; this proportion reached the 87% within the sixth year of treatment. Conclusions. Mepolizumab proved to be effective in real-life after 6 years of treatment, inducing a complete clinical remission in the 46.8% of patients, with sustained improvements in quality of life, exacerbation rate, OCS intake and lung function.

    Keywords: Severe asthma, Mepolizumab, biomarkers, Outcome, Disability, Rehabilitation, Occupational Medicine

    Received: 14 Jun 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Stanziola, Candia, Nazzaro, Caso, Merola, Gallotti and Maniscalco. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mauro Maniscalco, IRCCS Fondazione Salvatore Maugeri, Pavia, 27100, Lombardy, Italy

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