Treating Eosinophilic COPD With Mepolizumab
Findings suggest that esinophilic airway inflammation contributes to COPD exacerbations.
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 in the New England Journal of Medicine to coincide with the European Respiratory Society International Congress, held from September 9-13 in Milan.
Ian D. Pavord, MBBS, DM, from the University of Oxford in the United Kingdom, and colleagues performed 2 phase 3, randomized trials comparing mepolizumab (100 mg in METREX [ClinicalTrials.gov identifier NCT02105948] and 100 or 300 mg in METREO [ClinicalTrials.gov identifier: NCT02105961]) with placebo in patients with COPD with a history of moderate or severe exacerbations while taking inhaled glucocorticoid-based triple maintenance therapy.
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% CI, 0.68-0.98; adjusted P =.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% CI, 0.65-0.98; adjusted P =.07] and 0.86 [95% CI, 0.70-1.05; adjusted P =.14], respectively).
"This finding suggests that eosinophilic airway inflammation contributes to COPD exacerbations," the authors write.
Disclosures: The study was partially funded by GlaxoSmithKline, the manufacturer of mepolizumab.
- Pavord ID, Chanez P, Criner GJ, et al. Mepolizumab for eosinophilic chronic obstructive pulmonary disease [published online September 12, 2017]. N Engl J Med. doi:10.1056/NEJMoa1708208
- McDonald CF. Eosinophil biology in COPD [published online September 12, 2017]. N Engl J Med. doi:10.1056/NEJMe1710326