Mepolizumab and Exacerbations of Refractory Eosinophilic Asthma

Abstract

BACKGROUND-Exacerbations of asthma are associated with substantial morbidity and mortality and with considerable use of health care resources. Preventing exacerbations remains an important goal of therapy. There is evidence that eosinophilic inflammation of the airway is associated with the risk of exacerbations.

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

“…From a pragmatic, clinical perspective, phenotypic traits can be used in the daily clinical care to target-specific treatments: eosinophilia combined with exacerbations predicts effect of anti-IL5 [27] and patients with fixed airflow obstruction and exacerbations may benefit from tiotropium [28]. Furthermore, perennial allergic sensitization, airflow obstruction (FEV1 < 80%) and exacerbations predict effect of anti-IgE [5].…”

Improving the diagnosis of eosinophilic asthma

“…Second, the term eosinophilic asthma is used to describe a subphenotype of severe asthma, that is, asthma that is characterized by active eosinophilic inflammation, which remains uncontrolled and is associated with active eosinophilic inflammation despite the adequate use of high-dose corticosteroid treatment [14]. Wenzel and colleagues first described this 'eosinophil high' severe asthma phenotype when performing bronchial biopsies and showed that it was associated with airway remodeling and risk of near-fatal asthma attacks [15].…”

Potential Role of Serum Periostin in the Early Detection of Bronchial Asthma in Children

“…Однако, оказалось, что при исполь-зовании моноклональных антител, нейтрализующих IL5 (меполизумаб, mepolizumab), в сочетании с ингаляцион-ными ГКС лишь частично снижалось количество эози-Обзор литературы нофилов в дыхательных путях [30]. Клинически при при-менении меполизумаба отмечалось снижение частоты обострений БА, улучшение качества жизни без улучшения функции дыхательных путей и снижения гиперреактив-ности бронхов [31]. Апробация другого препарата, ней-трализующего IL5, -реслизумаба (reslizumab) в рандо-мизированном плацебоконтролируемом исследовании показала его положительное влияние на контроль астмы, документированный улучшением показателя ОФВ 1 , что, по мнению исследователей, подтверждало влияние эози-нофилов на течение БА и ее исходы [32].…”