Mepolizumab for COPD with Eosinophilic Phenotype following Hospitalization

• DOI: 10.1056/evidoa2500012
• Publication Date: 2025-05-01T01:03:50Z
• Authors: Cara A. Flynn; Hamish J.C. McAuley; Omer Elneima; Hnin W.W. Aung; Wadah Ibrahim; Thomas J.C. Ward; Michelle Bourne; Tracey D. Thornton; Vijay Mistry; Hannah R. Gilbert; Ghazala Waheed; Adam K.A. Wright; Rachel A. Evans; Michael C. Steiner; Cassandra L. Brookes; Christopher E. Br...; Neil J. Greening

Admission to hospital with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated a high risk morbidity and mortality. Biologic treatment reduces COPD exacerbations in patients eosinophilic inflammation. Mepolizumab, monoclonal antibody interleukin 5, inflammation, but its effects on future hospitalization mortality are uncertain. In this phase 2b, double-blind, placebo-controlled trial, we randomly assigned hospitalized AECOPD blood eosinophil count greater than or equal 300 cells/μl any time the preceding 12 months receive either mepolizumab 100 mg placebo every 4 weeks for 48 weeks, initiated at discharge. The primary end point was readmission death from cause. Key secondary points included number readmissions, exacerbations, health-related quality life. A total 238 were assigned. median due cause 25.4 26.1 groups, respectively, Kaplan-Meier estimates 33.9% 31.0%, respectively (hazard ratio, 0.96; 95% confidence interval [CI], 0.70 1.32; P=0.811). adjusted mean readmissions 1.65 (95% CI, 1.25 2.05) 1.85 1.42 2.29) (risk 0.89; 0.64 1.25). moderate severe 2.80 2.36 3.23) 3.45 2.94 3.95) ratio 0.81; 0.66 1.00). numbers adverse events serious similar between groups. No event attributed intervention. Patients inflammation within prior months, had no benefit following weeks. observed change which null upper bound interval, direction previous trials. (Funded by GSK plc; ClinicalTrials.gov number, NCT04075331.).