Heart failure signal with mepolizumab in eosinophilic COPD

Abstract This Letter to the Editor raises concerns about the increased incidence of heart failure observed in the mepolizumab group in the MATINEE trial. Given the high cardiovascular burden in COPD patients, we highlight possible biological mechanisms and population-level implications, and urge further evaluation of heart failure risk before expanding the clinical use of IL-5–targeting biologics in eosinophilic COPD.