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. 2025 May 1;42(3):231-244.
doi: 10.4103/lungindia.lungindia_442_24. Epub 2025 Apr 29.

Improving patient outcomes: Mepolizumab's impact in IL-5-mediated diseases

Dipti Gothi  1 , Raghupathi Narasimhan  2 , Randeep Guleria  3 , Manu Chopra  4 , Aanchal Gvalani  5 , Rashmi Hegde  5
Affiliations

Improving patient outcomes: Mepolizumab's impact in IL-5-mediated diseases

Dipti Gothi et al. Lung India. .

Abstract

The Interleukin-5 (IL-5)-mediated pathogenic role of eosinophils in airway disorders including severe eosinophilic asthma (SEA), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic granulomatosis with polyangiitis (EGPA), and rare hyper-eosinophilic syndrome (HES) is well established. Mepolizumab, an IL-5-targeting humanised antibody, is approved as an add-on maintenance therapy for SEA, EGPA, CRSwNP, and HES. Here, we review the safety and efficacy findings of mepolizumab in clinical trials and real-world evidence studies in patients with SEA, CRSwNP, EGPA, and HES. We specifically explore the data on mepolizumab that support early initiation of IL-5-targeted therapy to maximise its corticosteroid-sparing effect. This review consolidates the clinical data on mepolizumab, highlights other promising IL-5-targeting agents, and supports the IL-5 pathway as the key therapeutic target across eosinophilic indications.

Keywords: CRSwNP; EGPA; IL-5; NUCALA; eosinophilic asthma; hyper-eosinophilic syndrome hyper-eosinophilia; mepolizumab.

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Conflict of interest statement

Dipti Gothi, Raghupathi Narasimhan, Randeep Guleria, and Manu Chopra declares no conflict. Aanchal Gvalani and Rashmi Hegde are employees of GSK.

Figures

Figure 1
Figure 1
Efficacy and safety of mepolizumab in the clinical and real worlds. ACQ-5, asthma control questionnaire-5; CS, corticosteroid; CRSwNP, chronic rhinosinusitis with nasal polyposis; EGPA, eosinophilic granulomatosis with polyangiitis; FDA, Food and Drug Administration; HES, hyper-eosinophilic syndrome; NP, nasal polyp; SEA, severe eosinophilic asthma
Figure 2
Figure 2
Journey of mepolizumab from clinical development to real-world use. *As extracted from clinicaltrial.gov on 08 Aug 2023, not-active, not-recruiting, withdrawn studies are not included. ‡Records extracted from PuBMed with keywords RWE/observational/retrospective; mepolizumab and further selected based on relevance. CRSwNP, chronic rhinosinusitis with nasal polyposis; EGPA, eosinophilic granulomatosis with polyangiitis; FDA, Food and Drug Administration; HES, hyper-eosinophilic syndrome; Ph, phase; SEA, severe eosinophilic asthma; RWE, real-world evidence
See this image and copyright information in PMC

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