The First Case of Mepolizumab for the Treatment of the Prednisone-Dependent Asthma in China: A Case Report

Wang Ye1#, Xiaoyan Z2#, Bin X2, Hongmei Z2* and Chen W2,3*

1Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, School of Clinical Medicine, Beijing University of Chinese Medicine, China
2National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Center of Respiratory Medicine, China-Japan Friendship Hospital, China
3Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, China
#These authors contributed equally to this work

^*Correspondance to: Zhao Hongmei 

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Abstract:

Asthma is a chronic disease characterized by inflammation and narrowing of the airways in the lungs that lead to symptoms such as wheezing, cough, tightness of breath, and chest tightness. It is treated with Inhaled Corticosteroids (ICS), bronchodilators, and Oral Corticosteroids (OCS). Severe refractory asthma is treated with biological therapeutics. Long-term treatment with OCS is associated with systemic adverse effects, including easy bruising and increased risk of osteoporosis. The local adverse effects of ICS include oral thrush and dysphonia. Mepolizumab is a monoclonal antibody that blocks the interaction of the Interleukin 5 (IL-5) pro-inflammatory cytokine with its receptor, thereby reducing the eosinophil counts in blood and inhibiting eosinophilic inflammation in the airways of patients with asthma. In this case study, a middle-aged male Chinese patient with a history of severe asthma was diagnosed with severe prednisone-dependent eosinophilic asthma with persistent symptoms despite OCS treatment. The patient was diagnosed with type 2 airway inflammation with high blood eosinophil counts (>150/μl), higher proportion of eosinophils in the induced sputum (>2%) and high Fractional exhaled Nitric Oxide (FeNO) levels (>20 ppb). We initiated treatment with mepolizumab and showed that the Absolute Eosinophil Counts (AECs) and serum IL-5 levels returned to normal. Moreover, mepolizumab treatment allowed lowering of prednisone dosage without affecting symptoms. and the serum and induced sputum eosinophil counts returned to normal. However, the patient had to discontinue treatment with mepolizumab because of financial constraints. This resulted in the recurrence of some asthma indicators such as increased AECs and high serum IL-5 levels. In conclusion, our data showed that mepolizumab treatment resulted in significant improvement in symptoms associated with severe prednisonedependent eosinophilic asthma in this patient. This is the first case study from China for treatment of a severe asthma patient with mepolizumab.

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Cite the Article:

Wang Ye, Xiaoyan Z, Bin X, Hongmei Z, Chen W. The First Case of Mepolizumab for the Treatment of the Prednisone-Dependent Asthma in China: A Case Report. Ann Clin Case Rep. 2024; 9: 2599.