Summary

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• This summary is based on the review of 34 systematic review(s)/meta-analysis(es). ^[1-35]
• Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): Mepolizumab may improve disease-specific quality of life and reduce disease severity in CRSwNP patients, although evidence remains uncertain for its impact on disease severity and serious adverse events.
• Severe Eosinophilic Asthma (SEA): Mepolizumab reduces exacerbations by approximately 50% in SEA patients, with long-term data showing sustained reductions; real-world studies reported consistent reductions in exacerbations (50%-90%) across varied patient groups over 6-24 months. The drug shows similar efficacy to other biologics like benralizumab and dupilumab in reducing exacerbation rates and enhancing lung function.
• Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis (AAV): Mepolizumab demonstrated efficacy in reducing sinonasal symptoms and relapse rates in eosinophilic granulomatosis with polyangiitis (EGPA), showing particular benefit in managing this subtype of ANCA-associated vasculitis.
• Combined Asthma and CRSwNP: For patients with combined asthma and CRSwNP, mepolizumab contributed to significant improvements in lung function and quality of life after 24 weeks of treatment.
• Safety in CRSwNP: Mepolizumab and other biologics increased the risk of rheumatic adverse events (AEs) compared to placebo, with arthralgia being the most frequently reported. Injection-site reactions were also more common with higher doses (100 mg every 4 weeks) than with lower doses (75 mg every 4 weeks).
• Safety in SEA: Mepolizumab was associated primarily with mild injection site reactions and headaches, with a lower incidence of serious adverse events (SAEs) than placebo. Real-world data showed consistency with clinical trials, revealing no new safety concerns.
• General Safety Across Conditions: Anti-drug antibodies (ADAs) were observed at a rate of 3.63% in mepolizumab studies, with neutralizing antibodies present at approximately 0%. In chronic obstructive pulmonary disease (COPD) patients, mepolizumab's safety profile was comparable to placebo, with no significant differences in treatment discontinuation or serious adverse events.
• Studies on mepolizumab included diverse patient populations, demonstrating consistent efficacy across subgroups such as patients with SEA with frequent exacerbations, CRSwNP, and ANCA-AAV. Specifically, efficacy was observed across various demographic and clinical characteristics, including age of asthma onset, lung function levels, and presence of comorbidities such as upper respiratory and cardiovascular conditions.