Treatment With Mepolizumab on Patients With Severe Refractory Eosinophilic Asthma

NCT ID: NCT05063981

Last Updated: 2025-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

15 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-11-25

Study Completion Date

2025-09-02

Brief Summary

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Understanding how Interleukin-5 blockade modulates both immune and metabolic pathways may clarify the multidimensional impact of biologic therapy in severe eosinophilic asthma. Therefore, this study aimed to assess the impact of mepolizumab on the nasal, bronchial, and systemic metabolomic profiles of consecutive patients with SEA and to explore the associations between these compartment-specific changes and clinical, inflammatory, and functional outcomes.

Detailed Description

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We conducted a prospective, observational, multicenter cohort study of SEA adult individuals initiating mepolizumab, with 12-month follow-up. Consecutive patients referred to the Pulmonary Rehabilitation Units of the Istituti Clinici Scientifici Maugeri IRCCS in Telese Terme and Tradate, Italy, from September 2021 to September 2023, were screened for eligibility based on the following inclusion criteria: eligibility for mepolizumab treatment according to clinical practice; age between 18 and 75 years; diagnosis of severe eosinophilic refractory asthma, defined as peripheral blood eosinophil count (BEC) \> 300 cells/μL and at least two documented exacerbations within the previous 12 months; and ongoing treatment with high daily doses of inhaled corticosteroids (ICS) combined with long-acting β2-agonists (LABA), plus at least one additional controller medication for a minimum of 12 months.

Exclusion criteria included: current smoking; diagnosis of other chronic pulmonary diseases; coexisting chronic rhinosinusitis with nasal polyps; use of systemic corticosteroids at any dose within the 6 weeks prior to enrollment; use of immunosuppressive therapies; receipt of live attenuated vaccines within 30 days prior to enrollment; current or recent history (within the last 5 years) of malignancy, except in cases of complete remission; diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA); upper or lower respiratory tract infections within 30 days prior to signing informed consent or during the screening/run-in period; any clinically significant abnormalities identified during screening through physical examination, vital signs assessment, hematology, or clinical chemistry, which, in the opinion of the investigator, could pose a risk to patient safety or interfere with study outcomes or compliance. Additional exclusion criteria were: known immunodeficiency (primary or secondary); pregnancy; concurrent treatment with other biologics for asthma or other conditions (except for stable allergen immunotherapy, defined as an unchanged dose and regimen at screening); prior biologic therapy for asthma within 6 months before starting mepolizumab; planned surgical procedures during the study period; and participation in another interventional or post-authorization safety study.

The study lasted 24 months, including a 12-month enrollment period followed by a 12-month follow-up. Timepoints at 6 and 12 months were prespecified to capture early consolidation of treatment response and its one-year persistence, in alignment with routine follow up. Prior to inclusion, all participants underwent a clinical examination to assess eligibility. Clinical history was recorded, including age at asthma onset, smoking status, aspirin intolerance, number of exacerbations in the previous year, and asthma control level. Smoking status was recorded as never, former, or current, and current smokers were excluded. Occupational and specific environmental exposures were not systematically collected in this study. Evaluations were performed at baseline (T0), 6 (T6), and 12 months (T12) after initiation of treatment. At each timepoint, respiratory function was assessed and multiple biological matrices were collected to test markers of T2 inflammation and enable metabolomic profiling.

Conditions

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Severe Eosinophilic Asthma

Keywords

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asthma chronic respiratory disease mepolizumab rehabilitation inflammation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Severe eosinophilic asthma

Patients with severe refractory eosinophilic asthma

Mepolizumab

Intervention Type DRUG

The effects of treatment with Mepolizumab were evaluated on clinical and laboratory markers of systemic inflammation during a 12 months follow-up period in multiple biological matrices.

Interventions

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Mepolizumab

The effects of treatment with Mepolizumab were evaluated on clinical and laboratory markers of systemic inflammation during a 12 months follow-up period in multiple biological matrices.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Eligibility for mepolizumab treatment according to clinical practice;
* age between 18 and 75 years;
* diagnosis of severe eosinophilic refractory asthma, defined as peripheral blood eosinophil count (BEC) \> 300 cells/μL and at least two documented exacerbations within the previous 12 months;
* ongoing treatment with high daily doses of inhaled corticosteroids (ICS) combined with long-acting β2-agonists (LABA), plus at least one additional controller medication for a minimum of 12 months.

Exclusion Criteria

* current smoking;
* diagnosis of other chronic pulmonary diseases;
* coexisting chronic rhinosinusitis with nasal polyps;
* use of systemic corticosteroids at any dose within the 6 weeks prior to enrollment;
* use of immunosuppressive therapies;
* receipt of live attenuated vaccines within 30 days prior to enrollment;
* current or recent history (within the last 5 years) of malignancy, except in cases of complete remission;
* diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA);
* upper or lower respiratory tract infections within 30 days prior to signing informed consent or during the screening/run-in period;
* any clinically significant abnormalities identified during screening through physical examination, vital signs assessment, hematology, or clinical chemistry, which, in the opinion of the investigator, could pose a risk to patient safety or interfere with study outcomes or compliance.
* known immunodeficiency (primary or secondary);
* pregnancy;
* concurrent treatment with other biologics for asthma or other conditions (except for stable allergen immunotherapy, defined as an unchanged dose and regimen at screening); prior biologic therapy for asthma within 6 months before starting mepolizumab; planned surgical procedures during the study period;
* participation in another interventional or post-authorization safety study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Palermo

OTHER

Sponsor Role collaborator

National Research Council

UNKNOWN

Sponsor Role collaborator

Istituti Clinici Scientifici Maugeri SpA

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Istituti Clinici Scientifici Maugeri IRCCS

Telese Terme, BN, Italy

Site Status

Istituti Clinici Scientifici Maugeri IRCCS

Tradate, Varese, Italy

Site Status

Countries

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Italy

References

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Maniscalco M, Ambrosino P, Candia C, Di Stefano A, Gnemmi I, Zappa M, Ambrosino N, Visca D, Motta A. Cytokine and Metabolomic Signatures of Mepolizumab Response Across Upper and Lower Airway Compartments in Severe Eosinophilic Asthma: An Exploratory Analysis. Pharmaceuticals (Basel). 2025 Nov 10;18(11):1704. doi: 10.3390/ph18111704.

Reference Type RESULT
PMID: 41304949 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Informed Consent Form

View Document

Related Links

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Other Identifiers

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Pascale 09/2020

Identifier Type: -

Identifier Source: org_study_id