Mepolizumab

Aka: Mepolizumab, Nucala

advertisement

II. Indications

  1. See Asthma Monoclonal Antibody
  2. Third-line agents for refractory, Type 2 Asthma (Allergic Asthma or Eosinophilic Asthma, represents 50% of Asthma)
    1. Despite long acting Bronchodilator and Inhaled Corticosteroids
  3. One of the following findings present
    1. Blood Eosinophils >150/uL
    2. Sputum Eosinophils >2%
    3. Ferrous Nitrous Oxide >20 parts per billion
    4. Maintenance oral Corticosteroids required

III. Dosing

  1. May be used in age >=6 years old
  2. Adult (age >= 12 years): 100 mg SQ every 4 weeks
  3. Child (age 6 to 11 years): 40 mg SQ every 4 weeks
  4. Subcutaneous (SQ) injection sites include upper arm, Abdomen and thigh

IV. Mechanism

  1. Interleukin-5 Antagonist (alpha-directed cytolytic Monoclonal Antibody, IgG1 Kappa)
    1. Similar to Benralizumab (Fasenra)
  2. Binds Interleukin 5 receptor on Eosinophils and Basophils (Asthma-related inflammatory cells)
    1. Marks these inflammatory cells for Natural Killer Cell mediated death

V. Adverse Effects

  1. See Asthma Monoclonal Antibody
  2. Common
    1. Headache (20%)
    2. Injection site reaction (8%)
    3. Back pain (5%)
    4. Fatigue (5%)
  3. Uncommon
    1. Angioedema
    2. Fever
    3. Urinary Tract Infection

VI. Safety

  1. Unknown safety in pregnancy (registry exists)
  2. Unknown safety in Lactation
    1. Present in small amounts in Breast Milk

VII. Resources

  1. Biologic Therapy in Asthma
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405559/
  2. Mepolizumab (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fefb887c-e4ac-431e-8893-e9d1a5a63fea

VIII. References

  1. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  2. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
  3. (2018) Biologics for Asthma, Presc Lett
  4. Narasimhan (2021) Am Fam Physician 103(5): 286-90 [PubMed]
  5. Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]
  6. Ortega (2014) N Engl J Med 371(13): 1198-207 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Mepolizumab." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Related Topics in Pharmacology

advertisement