Mepolizumab: New Biologics Treatment for Severe Eosinophilic Asthma

Abstract

Severe eosinophilic asthma is a difficult-to-treat condition despite using high-dose inhaled corticosteroids combined with long-acting β2-agonists. Patients with this phenotype are at increased risk of recurrent exacerbations, reduced quality of life, and prolonged dependence on oral corticosteroids. In case of uncontrolled asthma, as well as asthmatic symptom that is related to eosinophilic level and allergy, treatment with biologics is suggested. Mepolizumab, a humanized monoclonal antibody, is a new biologics. It binds to interleukin-5, thereby reducing the survival and activation of eosinophils and leading to a significant decrease in circulating and airway eosinophils. Evidence from randomized controlled trials and real-world studies demonstrates that mepolizumab significantly reduces the frequency of asthma exacerbations, decreases the requirement for maintenance oral corticosteroids, improves lung function, and enhances quality of life, statistically significant compared to placebo. The safety profile is favorable, with most adverse events being mild, including headache, nasopharyngitis, and injection site reactions. However, rare cases of severe hypersensitivity reactions such as anaphylaxis have been reported. In conclusion, mepolizumab represents an effective and well-tolerated therapeutic option for patients with severe eosinophilic asthma who remain uncontrolled on standard therapy.