Mepolizumab Shows Promising Treatment of Severe Eosinophilic Asthma

In a recent multicenter study, Giulia Scioscia and peers found that in patients with severe eosinophilic asthma switching from mepolizumab to benralizumab can lead to improved treatment outcomes. The findings were published in Journal of Clinical Medicine.

Mepolizumab and benralizumab are monoclonal antibodies targeted against anti-IL-5 and anti-IL5R, respectively, and are commonly used in the treatment of severe eosinophilic asthma. These medications have been shown to reduce exacerbation rates and maintain oral corticosteroid requirements in patients with this condition.

The study included twenty-five patients with severe eosinophilic asthma who had been receiving mepolizumab for at least 12 months but showed a partial or total lack of clinical remission. The patients were switched to benralizumab, and their responses were assessed over a six-month period.

The results of the study revealed significant improvements in asthma control after the switch to benralizumab. At six months of treatment, patients exhibited significantly higher scores on the Asthma Control Test (ACT) compared to their scores while on mepolizumab. Furthermore, the number of daily short-acting beta-agonist (SABA) inhalations decreased significantly after six and twelve months of treatment with benralizumab compared to mepolizumab. Additionally, the intake of oral corticosteroids (OCS) was significantly reduced in patients receiving benralizumab.

Importantly, the study also identified a subgroup of patients with severe eosinophilic asthma and nasal polyposis who experienced marked improvements in asthma control, suppressed blood eosinophil levels, and a reduction in exacerbations following treatment with benralizumab.

These findings suggest that patients who initially showed a partial response to mepolizumab may benefit from switching to benralizumab. The study highlights the complexity of treating severe eosinophilic asthma and underscores the importance of personalized therapeutic choices based on individual patient factors. While this research provides valuable insights, further studies are warranted to validate these findings in larger patient populations and to explore the long-term effects of switching between these biologic medications. 

Source:

Scioscia, G., Tondo, P., Nolasco, S., Pelaia, C., Carpagnano, G. E., Caiaffa, M. F., Valenti, G., Maglio, A., Papia, F., Triggiani, M., Vatrella, A., Foschino Barbaro, M. P., & Crimi, C. (2023). Benralizumab in Patients with Severe Eosinophilic Asthma: A Multicentre Real-Life Experience. In Journal of Clinical Medicine (Vol. 12, Issue 13, p. 4362). MDPI AG. https://doi.org/10.3390/jcm12134362