Drug Action
Mepolizumab is a humanised anti- interleukin-5 (anti-IL-5) monoclonal antibody; it reduces the production and survival of eosinophils.
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Drug reference
Mepolizumab is a humanised anti- interleukin-5 (anti-IL-5) monoclonal antibody; it reduces the production and survival of eosinophils.
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Add on treatment for severe refractory eosinophilic asthma (under expert supervision) ▶BY SUBCUTANEOUS INJECTION ▶Adult: 100 mg every 4 weeks
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Helminth infection CAUTIONS, FURTHER INFORMATION ▶Helminth infections Manufacturer advises pre-existing helminth infections should be treated before initiation of therapy; if patients become infected during treatment and do not respond to anti-helminth treatment, consider treatment interruption.
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Mepolizumab is a biological medicine. Biological medicines must be prescribed and dispensed by brand name, see Biological medicines and Biosimilar medicines, under Guidance on prescribing p. 1; manufacturer advises to record the brand name and batch number after each administration.
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NICE decisions ▶Mepolizumab for treating severe refractory eosinophilic asthma (January 2017) NICE TA431 Mepolizumab (Nucala ®), as an add-on to optimised standard therapy, is recommended as an option for treating severe refractory eosinophilic asthma in adults, only if: . the blood eosinophil count is 300 cells/microlitre or more in the previous 12 months, and . the person has agreed to and followed the optimised standard treatment plan and has had 4 or more asthma exacerbations requiring systemic corticosteroids in the previous 12 months or had continuous oral corticosteroids of at least the equivalent of prednisolone 5 mg per day over the previous 6 months, and . the manufacturer provides mepolizumab with the discount agreed in the patient access scheme. At 12 months of treatment: . stop mepolizumab if the asthma has not responded adequately, or . continue treatment if the asthma has responded adequately and assess response each year. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta431 Scottish Medicines Consortium (SMC) decisions SMC No. 1149/16 The Scottish Medicines Consortium has advised (June 2016) that mepolizumab (Nucala ®) is accepted for restricted use within NHS Scotland as an add-on treatment for severe refractory eosinophilic asthma in adults who have eosinophils of at least 150 cells/microlitre (0.15 6 109/L) at initiation of treatment and have had at least four asthma exacerbations in the preceding year or are receiving maintenance treatment with oral corticosteroids. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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▶Common or very common Abdominal pain upper. administration related reaction. back pain. eczema. fever . headache. hypersensitivity. increased risk of infection. nasal congestion Respiratory system
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Manufacturer advises avoid unless potential benefit outweighs risk—limited data available.
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Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises injection is given into the thigh, abdomen, or upper arm. Patients may self-administer Nucala ® pre-filled devices into the thigh or abdomen after appropriate training in preparation and administration.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Edetic acid (edta), polysorbates ▶Nucala (GlaxoSmithKline UK Ltd) A Mepolizumab 100 mg per 1 ml Nucala 100mg/1ml solution for injection pre-filled pens | 1 pre-filled disposable injection P £840.00 Nucala 100mg/1ml solution for injection pre-filled syringes | 1 pre- filled disposable injection P £840.00 Powder for solution for injection EXCIPIENTS: May contain Polysorbates ▶Nucala (GlaxoSmithKline UK Ltd) A Mepolizumab 100 mg Nucala 100mg powder for solution for injection vials | 1 vial P £840.00 (Hospital only)
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Asthma Patients and their carers should be advised to seek medical advice if their asthma remains uncontrolled or worsens after initiation of treatment.
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100 mg every 4 weeks
First-line fragment. Read the complete Indications and Dose section above.
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