2. Academic Validation
  3. From DREAM to REALITI-A and beyond: Mepolizumab for the treatment of eosinophil-driven diseases

From DREAM to REALITI-A and beyond: Mepolizumab for the treatment of eosinophil-driven diseases

  • Allergy. 2022 Mar;77(3):778-797. doi: 10.1111/all.15056.
Ian D Pavord 1,  Elisabeth H Bel 2,  Arnaud Bourdin 3 4,  Robert Chan 5,  Joseph K Han 6,  Oliver N Keene 7,  Mark C Liu 8,  Neil Martin 9 10,  Alberto Papi 11,  Florence Roufosse 12,  Jonathan Steinfeld 13,  Michael E Wechsler 14,  Steven W Yancey 15
Affiliations

Affiliations

  • 1 Nuffield Department of Medicine and Oxford Respiratory NIHR BRC, University of Oxford, Oxford, UK.
  • 2 Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • 3 INSERM 12, F-CRIN, Clinical Research Initiative In Severe Asthma: a Lever for Innovation & Science (CRISALIS), France.
  • 4 Service de Pneumologie and INSERM CNRS, CHU Montpellier, Université de Montpellier, Montpellier, France.
  • 5 Clinical Sciences, GSK R&D, Stockley Park, UK.
  • 6 Department of Otolaryngology, Head & Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
  • 7 Biostatistics, GSK, Brentford, UK.
  • 8 Divisions of Allergy and Clinical Immunology, Pulmonary and Critical Care Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA.
  • 9 Global Medical Affairs, GSK, Brentford, UK.
  • 10 Institute for Lung Health, University of Leicester, Leicester, UK.
  • 11 Research Center on Asthma and COPD, University of Ferrara, Ferrara, Italy.
  • 12 Department of Internal Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
  • 13 Respiratory Research & Development, GSK, Collegeville, PA, USA.
  • 14 Department of Medicine, National Jewish Health Cohen Family Asthma Institute, Denver, CO, USA.
  • 15 Respiratory Therapeutic Area Unit, GSK, Research Triangle Park, NC, USA.
PMID: 34402066 DOI: 10.1111/all.15056
Abstract

Effective treatment of inflammatory diseases is often challenging owing to their heterogeneous pathophysiology. Understanding of the underlying disease mechanisms is improving and it is now clear that eosinophils play a complex pathophysiological role in a broad range of type 2 inflammatory diseases. Standard of care for these conditions often still includes oral corticosteroids (OCS) and/or cytotoxic immune therapies, which are associated with debilitating side effects. Selective, biological eosinophil-reducing agents provide treatment options that improve clinical symptoms associated with eosinophilic inflammation and reduce OCS use. Mepolizumab is a humanized monoclonal antibody that binds to and neutralizes interleukin-5, the major cytokine involved in eosinophil proliferation, activation, and survival. Mepolizumab is approved for the treatment of severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome. Additionally, the efficacy of add-on mepolizumab has been observed in patients with severe chronic rhinosinusitis with nasal polyposis and chronic obstructive pulmonary disease with an eosinophilic phenotype. Here, we review the development, approval, and real-world effectiveness of mepolizumab for the treatment of patients with severe eosinophilic asthma, from the DREAM to REALITI-A studies, and describe how knowledge from this journey extended to the use of mepolizumab and other biologics across a broad spectrum of eosinophilic diseases.

Keywords

clinical trials; eosinophilic diseases; interleukin-5; mepolizumab; real-world data.

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