Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 140, Issue 6, Pages 1509-1518Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2017.10.005
Keywords
Eosinophils; biomarkers; severe eosinophilic asthma
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Funding
- GlaxoSmithKline
- National Institute for Health Research [NF-SI-0510-10157] Funding Source: researchfish
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The last decade has seen the approval of several new biologics for the treatment of severe asthma-targeting specific endotypes and phenotypes. This review will examine how evidence generated from the mepolizumab clinical development program showed that blood eosinophil counts, rather than sputum or tissue eosinophil counts, evolved as a pharmacodynamic and predictive biomarker for the efficacy of treatment with mepolizumab in patients with severe eosinophilic asthma. Based on the available evidence and combined with clinical judgement, a baseline blood eosinophil threshold of 150 cells/mL or greater or a historical blood eosinophil threshold of 300 cells/mL or greater will allow selection of patients with severe eosinophilic asthma who are most likely to achieve clinically significant reductions in the rate of exacerbations with mepolizumab treatment.
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