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The following is a summary of “Long-Term Safety and Efficacy of Mepolizumab in Eosinophilic Granulomatosis With Polyangiitis,” published in the February 2025 issue of American College of Rheumatology by Wechsler et al. 

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare inflammatory disease managed with oral corticosteroids (OCS), which cause adverse effects. This open-label extension (OLE) study assessed the long-term safety and OCS-sparing effects of mepolizumab. 

Researchers conducted a retrospective study on EGPA, a rare inflammatory disease managed with OCS, which causes adverse effects.  

They conducted a multicenter OLE study (NCT03298061) enrolling patients with MIRRA needing OCS ≥5 mg/day up to 6 months post-MIRRA. They administered mepolizumab 300 mg subcutaneously every 4 weeks plus standard-of-care until discontinuation or approval in each country. They assessed adverse events (AEs) and OCS use. 

The results showed 100 patients enrolled with a mean standard deviation (SD) and median (min, max) exposure of 38.5 (27.0) and 27.0 (1.0, 89.0) months. On-treatment AEs occurred in 98% (43% treatment-related, 10% injection-site reaction), and serious AEs in 38% (6% treatment-related), with no new safety signals. Median (Q1, Q3) OCS dose dropped from 10.0 (7.8, 15.0) mg/day at baseline to 5.0 (0.0, 10.0) mg/day at exit. OCS >7.5 mg/day use fell from 75% to 32%, and 28% discontinued OCS. 

Investigators found long-term mepolizumab use was well tolerated and led to sustained OCS reductions. 

Source: acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.43146