Mepolizumab and eosinophil-mediated disease

Research output: Contribution to journalLiterature review

26 Citations (Scopus)

Abstract

Eosinophils are major pro-inflammatory cells that make a major contribution to diseases that affect the upper and lower airways, skin and gastrointestinal tract. Interleukin (IL)-5 is central to their maturation and release from the bone marrow together with their subsequent accumulation and activation in the tissues. Mepolizumab is a humanized monoclonal antibody (mAb) with potent IL-5 neutralizing effects that represents a potential treatment for eosinophilic diseases. Several clinical trials with mepolizumab reported that treatment of patients with mild to severe asthma resulted in a substantial reduction in blood and sputum eosinophil numbers. However, clinical outcomes were disappointing as there were no significant effects on airway hyper-reactivity or the late asthmatic reaction to inhaled allergen challenge. More recently two studies, one in patients with refractory eosinophilic asthma with a history of recurrent severe exacerbations and the other in patients with persistent sputum eosinophilia and symptoms despite systemic treatment with prednisone treatment, reported that monthly intravenous mepolizumab reduced sputum/blood eosinophilia, asthma exacerbations together with improvments in quality of life. Mepolizumab also appears to be an effective therapy for hypereosinophilic syndrome while other trials have shown efficacy of mepolizumab therapy in eosinophilic esophagitis. This review will consider the current status of the clinical development of mepolizumab for diseases with a significant eosinophilic component to their pathology.

Original languageEnglish
Pages (from-to)4774-4778
Number of pages5
JournalCurrent Medicinal Chemistry
Volume16
Issue number36
DOIs
Publication statusPublished - Dec 2009

Keywords

  • mepolizumab
  • IL-5
  • eosinophils
  • asthma
  • eosinophilic esophagitis
  • hypereosinophilic syndrome
  • monoclonal-antibody
  • anti-IL-5 treatment
  • allergic disease
  • receptor-alpha
  • asthma control
  • interleukin-5
  • airway
  • exacerbations

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