Mepolizumab Beneficial in COPD With Eosinophilic Phenotype
TUESDAY, Sept. 12, 2017 -- 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 Sept. 12 in the New England Journal of Medicine to coincide with the European Respiratory Society International Congress, held from Sept. 9 to 13 in Milan.
Ian D. Pavord, M.B.B.S., D.M., from the University of Oxford in the United Kingdom, and colleagues performed two phase 3, randomized trials comparing mepolizumab (100 mg in METREX and 100 or 300 mg in METREO) 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 percent confidence interval, 0.68 to 0.98; adjusted P = 0.04). 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 percent confidence interval, 0.65 to 0.98; adjusted P = 0.07] and 0.86 [95 percent confidence interval, 0.70 to 1.05; adjusted P = 0.14], respectively).
"This finding suggests that eosinophilic airway inflammation contributes to COPD exacerbations," the authors write.
The study was partially funded by GlaxoSmithKline, the manufacturer of mepolizumab.
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Posted: September 2017