Clinical efficacy of mepolizumab in the treatment of severe eosinophilic asthma in children

Abstract

Severe bronchial asthma in children remains a serious problem, which is caused by high mortality, side effects from therapy with high doses of glucocorticosteroids and a significant consumption of health resources. According to statistics from the Monitoring, Analysis and Strategic Health Development Department of the Ministry of Health of the Russian Federation, 1028.6 BA cases per 100,000 children under 14 years of age were registered in Russia in 2017. The article presents modern data on the pathogenesis of bronchial asthma, causes of therapy-resistant asthma, participation of interleukin-5 (IL-5) in the development of eosinophilic inflammation. Research data demonstrate the safety and effectiveness of anti-IL-5 therapy as a supplement to standard treatment for severe eosinophilic bronchial asthma and its poor control. Mepolizumab is the most widely researched anti-IL-5-monoclonal drug. It statistically significantly reduces the level of eosinophils in sputum, reduces the frequency of exacerbations and hospitalizations helps reduce maintenance therapy with glucocorticosteroids. As a result of randomized, placebo-controlled trials mepolizumab has been shown effective and safe in children 6 years of age and older, experts of leading world organizations approved its use for the treatment of severe eosinophilic asthma in children, what makes this drug the only one currently approved for use in patients in this age profile. However, further studies are needed to determine the optimal duration and long-term therapeutic efficacy in children.