Gothi Dipti, Narasimhan Raghupathi, Guleria Randeep, Chopra Manu, Gvalani Aanchal, Hegde Rashmi
Department of Pulmonary and Sleep Medicine, Postgraduate Institute of Medical Sciences and Research and Employees State Insurance Model Hospital, New Delhi, India.
Department of EBUS and Bronchial Thermoplasty Services, Apollo Specialty Hospital, Chennai, Tamil Nadu, India.
Lung India. 2025 May 1;42(3):231-244. doi: 10.4103/lungindia.lungindia_442_24. Epub 2025 Apr 29.
The Interleukin-5 (IL-5)-mediated pathogenic role of eosinophils in airway disorders including severe eosinophilic asthma (SEA), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic granulomatosis with polyangiitis (EGPA), and rare hyper-eosinophilic syndrome (HES) is well established. Mepolizumab, an IL-5-targeting humanised antibody, is approved as an add-on maintenance therapy for SEA, EGPA, CRSwNP, and HES. Here, we review the safety and efficacy findings of mepolizumab in clinical trials and real-world evidence studies in patients with SEA, CRSwNP, EGPA, and HES. We specifically explore the data on mepolizumab that support early initiation of IL-5-targeted therapy to maximise its corticosteroid-sparing effect. This review consolidates the clinical data on mepolizumab, highlights other promising IL-5-targeting agents, and supports the IL-5 pathway as the key therapeutic target across eosinophilic indications.
白细胞介素-5（IL-5）介导的嗜酸性粒细胞在包括严重嗜酸性粒细胞性哮喘（SEA）、伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）、嗜酸性肉芽肿性多血管炎（EGPA）和罕见的高嗜酸性粒细胞综合征（HES）等气道疾病中的致病作用已得到充分证实。美泊利珠单抗是一种靶向IL-5的人源化抗体，已被批准作为SEA、EGPA、CRSwNP和HES的附加维持疗法。在此，我们回顾了美泊利珠单抗在SEA、CRSwNP、EGPA和HES患者的临床试验及真实世界证据研究中的安全性和有效性结果。我们特别探讨了支持早期启动靶向IL-5治疗以最大化其糖皮质激素节省效应的美泊利珠单抗相关数据。本综述整合了美泊利珠单抗的临床数据，突出了其他有前景的靶向IL-5药物，并支持将IL-5途径作为嗜酸性粒细胞相关适应症的关键治疗靶点。
