Open AccessMepolizumab asthma treatment failure due to refractory airway eosinophilia, which responded to benralizumab
Author(s) -
Cook Alistair,
Harrington John,
Simpson Jodie L.,
Wark Peter
Publication year - 2021
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.742
Subject(s) - mepolizumab , benralizumab , medicine , eosinophilia , interleukin 5 , asthma , immunology , refractory (planetary science) , eosinophil , airway , monoclonal , airway hyperresponsiveness , monoclonal antibody , antibody , interleukin , surgery , cytokine , physics , astrobiology
Monoclonal antibodies directed against interleukin (IL)‐5, such as mepolizumab and benralizumab, are an effective and established treatment for severe eosinophilic asthma. Here, we present a patient with eosinophilic asthma with a partial clinical response to mepolizumab initially, as measured by these biomarkers, who when investigated was found to have refractory airway eosinophilia. Escalation of the mepolizumab dose led to further but still only partial response. A treatment trial with benralizumab was more successful and led to suppression of airway eosinophilia. We review the literature, focusing on eosinophil biology at the tissues and the different mechanisms of action of the two agents.