Mepolizumab Evaluated in COPD with Eosinophilic Phenotype

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Lower annual rate of moderate, severe exacerbations for patients receiving 100mg mepolizumab
Lower annual rate of moderate, severe exacerbations for patients receiving 100mg mepolizumab

HealthDay News — Patients with chronic obstructive pulmonary disease (COPD) with an eosinophilic phenotype may benefit from mepolizumab, a monoclonal antibody directed against interleukin-5, according to a study published online September 12 in the New England Journal of Medicine to coincide with the European Respiratory Society International Congress, held from September 9 to 13 in Milan.

Ian D. Pavord, MBBS, DM, from the University of Oxford in the United Kingdom, and colleagues performed two phase 3, randomized trials comparing mepolizumab (100mg in METREX and 100 or 300mg in METREO) with placebo in patients with COPD with a history of moderate or severe exacerbations while taking inhaled glucocorticoid-based triple maintenance therapy. 

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The researchers found that the mean annual rate of moderate or severe exacerbations in the modified intention-to-treat population with an eosinophilic phenotype was 1.40 and 1.71 per year in the mepolizumab and placebo groups in METREX (rate ratio, 0.82; 95% confidence interval, 0.68 to 0.98; adjusted P=0.04). The mean annual rate of moderate or severe exacerbations was 1.19 and 1.27 per year in the 100-mg and 300-mg mepolizumab groups, and 1.49 per year in the placebo group in METREO (rate ratios, 0.80 [95% confidence interval, 0.65 to 0.98; adjusted P=0.07] and 0.86 [95% confidence interval, 0.70 to 1.05; adjusted P=0.14], respectively).

"This finding suggests that eosinophilic airway inflammation contributes to COPD exacerbations," the authors write.

The study was partially funded by GlaxoSmithKline, the manufacturer of mepolizumab.

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