Skip to main content

Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease.

Publication ,  Journal Article
Pavord, ID; Chanez, P; Criner, GJ; Kerstjens, HAM; Korn, S; Lugogo, N; Martinot, J-B; Sagara, H; Albers, FC; Bradford, ES; Harris, SS ...
Published in: The New England journal of medicine
October 2017

Patients with chronic obstructive pulmonary disease (COPD) with an eosinophilic phenotype may benefit from treatment with mepolizumab, a monoclonal antibody directed against interleukin-5.We performed two phase 3, randomized, placebo-controlled, double-blind, parallel-group trials comparing mepolizumab (100 mg in METREX, 100 or 300 mg in METREO) with placebo, given as a subcutaneous injection every 4 weeks for 52 weeks in patients with COPD who had a history of moderate or severe exacerbations while taking inhaled glucocorticoid-based triple maintenance therapy. In METREX, unselected patients in the modified intention-to-treat population with an eosinophilic phenotype were stratified according to blood eosinophil count (≥150 per cubic millimeter at screening or ≥300 per cubic millimeter during the previous year). In METREO, all patients had a blood eosinophil count of at least 150 per cubic millimeter at screening or at least 300 per cubic millimeter during the previous year. The primary end point was the annual rate of moderate or severe exacerbations. Safety was also assessed.In METREX, the mean annual rate of moderate or severe exacerbations in the modified intention-to-treat population with an eosinophilic phenotype (462 patients) was 1.40 per year in the mepolizumab group versus 1.71 per year in the placebo group (rate ratio, 0.82; 95% confidence interval [CI], 0.68 to 0.98; adjusted P=0.04); no significant between-group differences were found in the overall modified intention-to-treat population (836 patients) (rate ratio, 0.98; 95% CI, 0.85 to 1.12; adjusted P>0.99). In METREO, the mean annual rate of moderate or severe exacerbations was 1.19 per year in the 100-mg mepolizumab group, 1.27 per year in the 300-mg mepolizumab group, and 1.49 per year in the placebo group. The rate ratios for exacerbations in the 100-mg and 300-mg mepolizumab groups versus the placebo group were 0.80 (95% CI, 0.65 to 0.98; adjusted P=0.07) and 0.86 (95% CI, 0.70 to 1.05; adjusted P=0.14), respectively. A greater effect of mepolizumab, as compared with placebo, on the annual rate of moderate or severe exacerbations was found among patients with higher blood eosinophil counts at screening. The safety profile of mepolizumab was similar to that of placebo.Mepolizumab at a dose of 100 mg was associated with a lower annual rate of moderate or severe exacerbations than placebo among patients with COPD and an eosinophilic phenotype. This finding suggests that eosinophilic airway inflammation contributes to COPD exacerbations. (Funded by GlaxoSmithKline; METREX and METREO ClinicalTrials.gov numbers, NCT02105948 and NCT02105961 .).

Altmetric Attention Stats
Dimensions Citation Stats

Published In

The New England journal of medicine

DOI

EISSN

1533-4406

ISSN

0028-4793

Publication Date

October 2017

Volume

377

Issue

17

Start / End Page

1613 / 1629

Related Subject Headings

  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Male
  • Leukocyte Count
  • Intention to Treat Analysis
  • Injections, Subcutaneous
  • Humans
  • Glucocorticoids
  • General & Internal Medicine
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pavord, I. D., Chanez, P., Criner, G. J., Kerstjens, H. A. M., Korn, S., Lugogo, N., … Sciurba, F. C. (2017). Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease. The New England Journal of Medicine, 377(17), 1613–1629. https://doi.org/10.1056/nejmoa1708208
Pavord, Ian D., Pascal Chanez, Gerard J. Criner, Huib A. M. Kerstjens, Stephanie Korn, Njira Lugogo, Jean-Benoit Martinot, et al. “Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease.The New England Journal of Medicine 377, no. 17 (October 2017): 1613–29. https://doi.org/10.1056/nejmoa1708208.
Pavord ID, Chanez P, Criner GJ, Kerstjens HAM, Korn S, Lugogo N, et al. Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease. The New England journal of medicine. 2017 Oct;377(17):1613–29.
Pavord, Ian D., et al. “Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease.The New England Journal of Medicine, vol. 377, no. 17, Oct. 2017, pp. 1613–29. Epmc, doi:10.1056/nejmoa1708208.
Pavord ID, Chanez P, Criner GJ, Kerstjens HAM, Korn S, Lugogo N, Martinot J-B, Sagara H, Albers FC, Bradford ES, Harris SS, Mayer B, Rubin DB, Yancey SW, Sciurba FC. Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease. The New England journal of medicine. 2017 Oct;377(17):1613–1629.

Published In

The New England journal of medicine

DOI

EISSN

1533-4406

ISSN

0028-4793

Publication Date

October 2017

Volume

377

Issue

17

Start / End Page

1613 / 1629

Related Subject Headings

  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Male
  • Leukocyte Count
  • Intention to Treat Analysis
  • Injections, Subcutaneous
  • Humans
  • Glucocorticoids
  • General & Internal Medicine
  • Female