mepolizumab (Nucala)

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Indications

* only biologic agent approved for Churg-Strauss disease[6]

Contraindications

  • avoid[5]; disproprotionate adverse events

Dosage

Adverse effects

Laboratory

Mechanism of action

Notes

  • FDA approved (Nov 2015)
  • editorialist notes that asthma exacerbations decreased by 50% with placebo in one study suggesting that frequent monitoring of patients may lead to better control without the need for expensive biologic therapy[1]
  • too expensive[3]

More general terms

References

  1. 1.0 1.1 Ortega HG et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med 2014 Sep 8; PMID: https://www.ncbi.nlm.nih.gov/pubmed/25199059
    Bel EH et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med 2014 Sep 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25199060
    Nair P Anti-interleukin-5 monoclonal antibody to treat severe eosinophilic asthma. N Engl J Med 2014 Sep 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25197762
  2. 2.0 2.1 Brown T FDA Approves Mepolizumab (Nucala ) for Severe Asthma. Medscape Oncology. Nov 4, 2015 http://www.medscape.com/viewarticle/853957
    FDA News Release. November 4, 2015 FDA approves Nucala to treat severe asthma. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm471031.htm
  3. 3.0 3.1 California Institute for Clinical and Economic Review, 2015 Mepolizumab (Nucala<TM>, GlaxoSmithKline plc.) for the Treatment of Severe Asthma with Eosinophilia: Effectiveness, Value, and Value-Based Price Benchmarks. http://ctaf.org/sites/default/files/u148/Asthma_Draft_Report_122115.pdf
  4. 4.0 4.1 Hein I Mepolizumab Showing Promise for High-Risk Eosinophilic COPD Medscape - Sep 13, 2017. http://www.medscape.com/viewarticle/885596
  5. 5.0 5.1 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
  6. 6.0 6.1 6.2 6.3 Medical Knowledge Self Assessment Program (MKSAP) 18, 19 American College of Physicians, Philadelphia 2018, 2022
  7. 7.0 7.1 Boyles S Mepolizumab Offers Relief for Chronic Sinus Trouble - Anti-IL5 biologic cut polyp size, need for surgery in chronic rhinosinusitis with nasal polyps. MedPsge Today. Sept 10, 2020 https://www.medpagetoday.com/meetingcoverage/ers/88539
    Hopkins C et al Add-on mepolizumab for chronic rhinosinusitis with nasal polyps: SYNAPSE study European Respiratory Society International Congress (ERS 2020)