NICE Approves Mepolizumab for Severe Eosinophilic Asthma

Dawn O'Shea

February 09, 2021

  • the blood eosinophil count is 300 cells/μL or more and the person has had at least four exacerbations needing systemic corticosteroids in the previous 12 months, or has had continuous oral corticosteroids of at least the equivalent of prednisolone 5 mg per day over the previous six months or

  • the blood eosinophil count is 400 cells/μL or more and the person has had at least three exacerbations needing systemic corticosteroids in the previous 12 months (also eligible for either benralizumab or reslizumab).

If mepolizumab, benralizumab or reslizumab are equally suitable, start treatment with the least expensive option, taking into account drug and administration costs, the guidance recommends.

At 12 months, stop mepolizumab if the asthma has not responded adequately. An adequate response is defined as:

  • a clinically meaningful reduction in the number of severe exacerbations needing systemic corticosteroids or

  • a clinically significant reduction in continuous oral corticosteroid use while maintaining or improving asthma control.

There is no evidence directly comparing mepolizumab with benralizumab and reslizumab. But an indirect comparison suggests that it works as well as benralizumab and reslizumab for people with a blood eosinophil count of 400 cells/μL or more.

Mepolizumab is cost saving compared with benralizumab and reslizumab, NICE concluded.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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