Severe Pediatric Asthma Therapy: Mepolizumab

Frontiers in Pediatrics

article

Nicola Ullmann¹  Francesca Peri¹  Olivia Florio¹  Federica Porcaro¹  Elisa Profeti¹  Alessandro Onofri¹  Renato Cutrera¹ 

[1] Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long Term Ventilation Unit, Academic Department of Pediatrics ,(DPUO), Bambino Gesù Children's Hospital;Department of Medicine, Surgery, and Health Sciences, University of Trieste;Respiratory Medicine Unit, University “Magna Graecia” of Catanzaro

关键词: asthma;    biologics;    treatment;    children;    adolescents;    mepolizumab;    anti-interleukin-5;    antibodies;   

DOI  :  10.3389/fped.2022.920066

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second controller. In this scenario, mepolizumab, a humanized monoclonal antibody, has proven to be effective in controlling eosinophil proliferation by targeting interleukin-5 (IL-5), a key mediator of eosinophil activation pathways. Mepolizumab is approved since 2015 for adults at a monthly dose of 100 mg subcutaneously and it has been approved for patients ≥ 6 years of age in 2019. Especially in children aged 6 to 11 years, mepolizumab showed a greater bioavailability, with comparable pharmacodynamics parameters as in the adult population. The recommended dose of 40 mg every 4 weeks for children aged 6 through 11 years, and 100 mg for patients ≥ 12 years provides appropriate concentration and proved similar therapeutic effects as in the adult study group. A marked reduction in eosinophil counts clinically reflects a significant improvement in asthma control as demonstrated by validated questionnaires, reduction of exacerbation rates, and the number of hospitalizations. Finally, mepolizumab provides a safety and tolerability profile similar to that observed in adults with adverse events mostly of mild or moderate severity. The most common adverse events were headache and injection-site reaction. In conclusion, mepolizumab can be considered a safe and targeted step-up therapy for severe asthma with an eosinophilic phenotype in children and adolescents.

【 授权许可】

CC BY