Efficacy of Mepolizumab in a cohort of patiens with severe eosinophilic asthma and bronchiectasis after 6 years of treatment: a single centre study

Efficacy of Mepolizumab in a cohort of patiens with severe eosinophilic asthma and bronchiectasis after 6 years of treatment: a single centre study <bold>Introduction:</bold> Mepolizumab is a humanized monocolonal antibody against IL5, mostly used in patients with severe eosinophilic asthma. <bold>Aim:</bold> To describe clinical improvement and safety of Mepolizumab in patients with severe eosinophilic asthma and bronchiectasis in real life after 6 years <bold>Methods and Materials:</bold> 86 patients with severe eosinophilic asthma have been enrolled (40 females) mean age 62y (range 21-82), identified according to the most recent guidelines. They started Mepolizumab treatment from January 2018 and they were followed up until December 2023. 17 patients (12 females) mean age 61.1y (range 41-79) had bronchiectasis. Chest HRCT showed abnormal cylindrical dilatation of the bronchial tree, lack of tapering, bronchial wall thickening, mucoid impaction and specific signs, such as signet ring sign and tram-track sign. <bold>Results:</bold> After 6 years it has been demonstrated a reduction of infectious exacerbations from 2.1 events/y pre-treatment to 0.4 events/y post treatment and a less use of antibiotics to treat them. No adverse reactions have been recorded during the treatment with Mepolizumab. <bold>Conclusions:</bold> Mepolizumab improves the symptomatology in patients with severe eosinophilic asthma and bronchiectasis and reduces the frequency of the infectious exacerbations and adverse outcomes.