MEPOLIZUMAB
Background and Date of Approval
Mepolizumab is a monoclonal antibody indicated for the treatment of severe eosinophilic asthma and eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome. Severe eosinophilic asthma involves elevated eosinophil levels (a type of white blood cell) in the airways, resulting in recurrent asthma attacks that persist despite ongoing treatment. Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare autoimmune condition characterised by inflammation of blood vessels and eosinophil infiltration into multiple organs, leading to respiratory symptoms, systemic manifestations, and potential organ damage. Mepolizumab is marketed under the brand name Nucala and received initial approval from the U.S. Food and Drug Administration (FDA) on November 4, 2015.
Uses
Mepolizumab treats Eosinophilic asthma and Eosinophilic granulomatosis with polyangiitis (EGPA).
How is it administered?
Mepolizumab is given as an injection by healthcare professionals. The dosage and duration of treatment will depend on the individual's condition and response to the medication and should be determined by a healthcare provider.
Side Effects
Mepolizumab, like any medication, can have side effects. Common side effects may include headache, injection site reactions (such as pain, redness, or swelling), back pain, and fatigue. Serious side effects are rare but can include allergic reactions, such as rash, itching, swelling, or difficulty breathing. In some cases, patients may experience increased risk of certain infections, such as respiratory tract infections.
Warnings
Mepolizumab carries several important warnings, including the potential for severe allergic reactions or anaphylaxis, increased risk of parasitic infections and herpes zoster (shingles), careful corticosteroid dose reduction, and the possibility of asthma-related events. Additionally, it may impact vaccine effectiveness, increase the risk of respiratory infections, and affect the immune system.
Precautions
Specific precautions should be taken in pediatric, pregnant, and nursing populations. It is crucial to discuss these warnings with your healthcare professional to understand the potential risks and benefits of mepolizumab treatment fully.
Word of Advice
Keep all scheduled appointments and follow-up visits to monitor your response to treatment and discuss any concerns or side effects. Inform your doctor of your medical history, including any previous infections, liver disease, and kidney disease. Seek immediate medical attention if you experience severe allergic reactions or other serious side effects. Avoid close contact with individuals who have active infections. Do not alter your mepolizumab treatment or corticosteroid dose without consulting your healthcare professional. Inform your doctor before receiving any vaccines during treatment. Safety and efficacy in children below six years of age have not been established.
References
Goodman & Gilmanâs, The Pharmacological Basis of Therapeutics, 12th edition, 2011,1044-1046. Glaxo Smith Kline, Electronic medicines compendium (EMC), [ Revised on 16 November 2022], [ Accessed on 30th May 2023], https://www.medicines.org.uk/emc/product/10563/pil GlaxoSmithKline LLC, US Food and Drug Administration, [ Revised on June 2019] [ Accessed on 30th May 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761122s000lbl.pdf
Frequently Asked Questions
Can I stop taking my other asthma medications once I start mepolizumab?
Mepolizumab is not intended to replace other asthma medications, including inhalers or oral medications. It is typically used as an add-on treatment for individuals with severe eosinophilic asthma who require additional control of their symptoms. Your healthcare professional should discuss and determine the use of other asthma medications.
Can I receive vaccinations while on mepolizumab?
Discussing vaccination schedules and specific vaccines with your healthcare professional while on mepolizumab is recommended. It may affect the effectiveness of certain vaccines, particularly live vaccines. Your healthcare professional can guide the appropriate timing and administration of vaccinations.
How long does it take for mepolizumab to start working?
The response to mepolizumab can vary among individuals. Some people may experience improved symptoms, such as reduced asthma exacerbations or improved lung function, within a few weeks of starting treatment. However, it may take several months to observe the full benefits of this medication. Regular follow-up with your healthcare professional is important to assess your response to treatment.
Will mepolizumab cause weight gain?
Weight gain is not commonly reported as a side effect of mepolizumab. However, individual responses to medication can vary, and some may experience weight gain due to other factors. If you have concerns about weight changes while taking this, discuss them with your healthcare professional.
Can mepolizumab be used in older adults?
Considering their overall health and potential interactions with other medications, Mepolizumab can be used in older adults with severe eosinophilic asthma or EGPA. However, individual assessment and monitoring by a healthcare professional are important to determine the suitability and safety of this medication in older adults.