NICE Recommends Mepolizumab for Severe Refractory Eosinophilic Asthma

Priscilla Lynch 

December 29, 2020

The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending mepolizumab (Nucala, GlaxoSmithKline) as an add-on treatment option for severe refractory eosinophilic asthma.

Around 8500 more people will now be eligible for this treatment.

Mepolizumab had been previously recommended by NICE as an option for a more restricted patient population. The new draft guidance means the treatment will now be available to a total of around 38,000 people in England.

Clinical trial evidence shows that mepolizumab is at least as clinically effective as treatment with reslizumab, which had previously been available to the 8500 patients now offered mepolizumab. The clinical effectiveness of mepolizumab is also comparable to benralizumab, another routine treatment recommended by NICE to treat people with severe eosinophilic asthma.

Additionally, mepolizumab was found to be a cost-effective use of NHS resources, and is therefore recommended for routine use. However, in situations where benralizumab and reslizumab are found to be equally suitable for the patient as mepolizumab, practitioners should start treatment with the least expensive option, said NICE.

Mepolizumab is injected once every four weeks throughout the course of treatment. If after 12 months of treatment there has not been an adequate response, the treatment should discontinue. Otherwise, it is recommended for continued use.

Dr Samantha Walker, Director of Research and Innovation at Asthma UK and the British Lung Foundation, said: “This decision to extend the population for this treatment will mean that people eligible for biologics will have a wider range of treatments available to them. This could be a game-changer for those who have had little success with other biologic treatments."

She said that many people with asthma are not getting a diagnosis or an opportunity to try these new treatments, but Asthma UK has developed a new online tool to help people determine if they might benefit from this treatment and how to seek a specialist referral.

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