Mepolizumab for Treatment of Asthma: Post-Approval Academic Practice Experience
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Mariel Rosati Benjamin, MD, Bruce S. Bochner, MD FAAAAI, Anju T. Peters, MD FAAAAI

Mepolizumab has been approved for treatment in severe eosinophilic asthma. However, there are no post-approval practice-based data on its effectiveness and safety.


We performed a retrospective chart review of patients who received mepolizumab for asthma and compared characteristics from 6 months prior to starting mepolizumab to 6 months after starting. Characteristics analyzed included demographics, history, asthma severity and eosinophil counts.


We recruited twenty-four patients who received at least 6 months of continuous mepolizumab. Mean age was 51.0±10.4 years and 17/24 (71%) were female. 19/24 (79%) had history of chronic rhinosinusitis (CRS), 14 of whom had nasal polyps. Immediately prior to starting mepolizumab, patients required a mean of 2.3±0.9 controller medications. 7/24 (29%) previously received omalizumab. After starting mepolizumab, eosinophil counts decreased by >90% (1.2±1.1 vs 0.11±0.10/mm3, p=0.0001). Total asthma exacerbations in 6 months decreased by >55% (2.2±1.8 vs 0.9±1.4, p=0.0006) and number of steroid courses in 6 months decreased by >60% (2.3±1.8 vs 0.9±1.2, p=0.0003). There was a small improvement in FEV1 (1.8±1.0 vs 1.9±1.0 liters, p=0.025). The 10 patients who began mepolizumab while on chronic daily prednisone significantly reduced their daily prednisone dosage (9.4±3.6 mg vs 4.0±4.0 mg, p=0.024). Based on overall global physician assessment, 22/24 (92%) had improvement in asthma control and 7/16 (44%) had improvement in CRS. A 36-year-old patient developed shingles, and 5 complained of new-onset fatigue.


Real-world treatment of eosinophilic asthma with mepolizumab was associated with reduced oral steroid use and improvement in lung function, disease control, and fewer asthma exacerbations with minimal adverse effects.