Mepolizumab for Eosinophilic Granulomatosis Reduces Glucocorticoid Use

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Researchers found that, compared with placebo, mepolizumab treatment correlated with significantly more accrued weeks of remission.
Researchers found that, compared with placebo, mepolizumab treatment correlated with significantly more accrued weeks of remission.

HealthDay News — Mepolizumab is associated with significantly more weeks in remission than placebo among patients with eosinophilic granulomatosis with polyangiitis, according to a study published in the New England Journal of Medicine.

Michael E. Wechsler, MD, from National Jewish Health in Denver, and colleagues conducted a multicenter phase 3 trial involving participants with relapsing or refractory eosinophilic granulomatosis with polyangiitis. In addition to standard care, participants were randomized to receive mepolizumab (n=68) or placebo (n=68) administered every 4 weeks for 52 weeks.

The researchers found that, compared with placebo, mepolizumab treatment correlated with significantly more accrued weeks of remission (28% vs 3% of participants had ≥24 weeks of accrued remission, respectively; OR, 5.91) and a higher percentage of participants in remission at weeks 36 and 48 (32% vs 3%; OR, 16.74). 

Remission did not occur in 47% and 81% of participants in the mepolizumab and placebo groups, respectively. The annualized relapse rate was 1.14 and 2.27 in the mepolizumab and placebo groups, respectively (rate ratio, 0.50). Overall, 44% and 7% of those taking mepolizumab and placebo had an average daily dose of prednisolone or prednisone of 4.0 mg or less per day during weeks 48 through 52 (OR, 0.20).

"The results of our trial show an advance for patients with this rare disease," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including GlaxoSmithKline, which manufactures mepolizumab and funded the study.

Reference

Wechsler ME, Akuthota P, Jayne D, et al. Mepolizumab or placebo for eosinophilic granulomatosis with polyangiitis. N Engl J Med 2017; 376:1921-1932. doi: 10.1056/NEJMoa1702079

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