Mepolizumab’s (Anti-Interleukin-5) Role in Severe Asthma: A Literature Review

Atikanur Atikanur, Dewi Wijaya, Indi Esha, Arya Marganda Simanjuntak

Abstract


One type of asthma that is difficult to treat is severe asthma, which is asthma that is uncontrolled even when the patient is taking medication or trigger factors. It can be treated with the finest therapy but will worsen if high-dose treatment is discontinued. Age, gender, obesity, hypersensitivity, and immunological factors are all directly related to the onset of asthma. A complicated illness, severe asthma has many clinical symptoms and treatment choices. Chronic airway inflammation and lung tissue remodeling are its defining features. This literature review aims to describe how mepolizumab works in patients with severe asthma. Mepolizumab mainly inhibits the IL-5 cytokine from binding to IL-5 receptor subunits through the nanomolar potential, which inhibits IL-5 from binding to receptors on the surface of eosinophils. In contrast to the placebo group, patients on mepolizumab had an average 50% decrease from the baseline Prednisone dosage. With Mepolizumab, the yearly exacerbation rate was 1.44 RR, while it was 2.12 RR with placebo. The injection of monoclonal antibodies, such as mepolizumab, as a form of therapy in addition to treating severe eosinophilic asthma is advised by the GINA guideline for 2022. Mepolizumab's mode of action blocks IL-5 from binding to receptors on eosinophil surfaces, which lowers eosinophil recruitment, activation, production, growth, and survival, as well as eosinophil-mediated inflammation.


Keywords


eosinophil, interleukin-5, mepolizumab, severe asthma

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References


Global Initiative for Asthma. 2022 GINA Report, Global strategy for asthma management and prevention. 2022.

Dragonieri S, Carpagnano GE. Biological therapy for severe asthma. Asthma Res Pract. 2021;7(1):12.

Csoma Z, Gál Z, Gézsi A, Herjavecz I, Szalai C. Prevalence and characterization of severe asthma in Hungary. Sci Rep. 2020;10(1):9274.

Toppila-Salmi S, Lemmetyinen R, Chanoine S, Karjalainen J, Pekkanen J, Bousquet J, et al. Risk factors for severe adult-onset asthma: A multi-factor approach. BMC Pulm Med. 2021;21:214.

Piuvezam MR, Ferreira LKDP, Monteiro TM, Vieira GC, Roberto Bezerra-Santos C. Severe asthma: Updated therapy approach based on phenotype and biomarker. In: Huang KHG, Tsai CHS, editors. Asthma Diagnosis and Management. Rijeka: IntechOpen; 2018. p. Ch. 8.

Perhimpunan Dokter Paru Indonesia. Pedoman diagnosis & penatalaksanaan asma di Indonesia. 2021.

Noujeim C, Bou Khalil P. Severe asthma: Moving from phenotype to endotype classification with updates on treatment. Journal of Nursing & Care. 2016;5.

Agache I, Akdis CA, Akdis M, Canonica GW, Casale T, Chivato T, et al. EAACI biologicals guidelines-Recommendations for severe asthma. Allergy. 2021;76(1):14–44.

Cavaliere C, Frati F, Ridolo E, Greco A, de Vincentiis M, Masieri S, et al. The spectrum of therapeutic activity of mepolizumab. Expert Rev Clin Immunol. 2019;15(9):959–67.

Shabbir S, Pouliquen IJ, Bentley JH, Bradford ES, C. Kaisermann M, Albayaty M. The pharmacokinetics and relative bioavailability of mepolizumab 100 mg liquid formulation administered subcutaneously to healthy participants: A randomized trial. Clin Pharmacol Drug Dev. 2020;9(3):375–85.

Morjaria JB, Emma R, Fuochi V, Polosa R, Caruso M. An evaluation of mepolizumab for the treatment of severe asthma. Expert Opin Biol Ther. 2019;19(6):491–500.

Jin HJ. Biological treatments for severe asthma. Yeungnam Univ J Med. 2020;37(4):262–8.

Wenzel SE. Severe adult asthmas: Integrating clinical features, biology, and therapeutics to improve outcomes. Am J Respir Crit Care Med. 2021;203(7):809–21.

Pelaia C, Vatrella A, Busceti MT, Gallelli L, Terracciano R, Savino R, et al. Severe eosinophilic asthma: from the pathogenic role of interleukin-5 to the therapeutic action of mepolizumab. Drug Des Devel Ther. 2017;11:3137–44.

Nakagome K, Nagata M. Involvement and possible role of eosinophils in asthma exacerbation. Front Immunol. 2018;9:2220.

Magnan A, Bourdin A, Prazma CM, Albers FC, Price RG, Yancey SW, et al. Treatment response with mepolizumab in severe eosinophilic asthma patients with previous omalizumab treatment. Allergy. 2016;71(9):1335–44.

Harrison T, Canonica GW, Chupp G, Lee J, Schleich F, Welte T, et al. Real-world mepolizumab in the prospective severe asthma REALITI-A study: Initial analysis. Eur Respir J. 2020;56(4):2000151.

Russell R, Brightling C. Mepolizumab for the reduction of exacerbations in severe eosinophilic asthma. Expert Rev Respir Med. 2016;10(6):607–17.

Karp J, Dhillon I, Panchmatia R, Javer A. Subcutaneous mepolizumab injection: An adjunctive treatment for recalcitrant allergic fungal rhinosinusitis patients with asthma. Am J Rhinol Allergy. 2021;35(2):256–63.




DOI: https://doi.org/10.36497/jri.v44i2.494

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Jurnal Respirologi Indonesia
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