Mepolizumab for treating severe eosinophilic asthma - guidance (TA671)

Mepolizumab, as an add-on therapy, is recommended as an option for severe refractory eosinophilic asthma in adults who have agreed to and followed an optimised standard treatment plan, under certain set clinical criteria. This guidance updates and replaces NICE TA guidance 431.

SPS commentary:

The set criteria for use are:

  • Eosinophil count ≥300/µL, and at least 4 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

or

  • Eosinophil count ≥400/µL and at least 3 exacerbations needing systemic corticosteroids in the previous 12 months (so they are also eligible for either benralizumab or reslizumab).

 

Response should be assessed each year, and mepolizumab stopped if the response has not been adequate.  Adequate response is defined as:

  • a clinically meaningful reduction in the number of severe exacerbations needing systemic corticosteroid

or

  • a clinically significant reduction in continuous oral corticosteroid use while maintaining or improving asthma control.

National Institute for Health and Care Excellence