Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease

Results from 2 phase III studies (METREX and METREO) show annual rate of moderate or severe exacerbations was lower in the mepolizumab group than in the placebo group in the METREX study, but no significant difference was noted in METREO study.

In METREX, the annual rate of moderate or severe exacerbations was lower in the mepolizumab group than in the placebo group (1.40 vs. 1.71 per year; rate ratio, 0.82; 95% confidence interval, 0.68 to 0.98; P=0.04). In contrast, no significant differences in exacerbation rates were detected in METREO, and there was no significant between-group difference in the rate of exacerbations that led to an emergency department visit or hospitalisation or in measures of patients’ symptoms in either trial.

 

NICE in their Technology Appraisal Guidance recommend mepolizumab, as an add-on to optimised standard therapy, for treating severe refractory eosinophilic asthma in adults, only if:

• the blood eosinophil count is 300 cells/microlitre or more in the previous 12 months and
• the person has agreed to and followed the optimised standard treatment plan and has had 4 or more asthma exacerbations needing systemic corticosteroids in the previous 12 months or has had continuous oral corticosteroids of at least the equivalent of prednisolone 5 mg per day over the previous 6 months and
• the company provides the drug with the discount agreed in the patient access scheme.