Idiopathic chronic eosinophilic pneumonia (ICEP) is an orphan lung disease characterized by concomitant systemic and local eosinophilia, along with bilateral lung infiltrates. Symptoms include dyspnea of subacute/chronic onset, cough, and general systemic signs. Although all patients do respond to oral corticosteroids, relapse rate is very high, which highlights the need for alternative therapies in case of relapsing ICEP. Mepolizumab is a fully humanized antibody directed against interleukin 5, a key growth factor of eosinophils. In the present study, we retrospectively studied the effect of off-label use of mepolizumab for relapsing ICEP.
Materials and Methods
All data from patients treated with mepolizumab for relapsing ICEP were included in our database and diagnoses were reviewed. We analyzed the effect of treatment on relapse rate, oral corticosteroids (OCS) use, and lung lesions on high-resolution computed tomography (HRCT).
We included ten patients in the final analysis, with a median follow-up of 9 months after initiation of mepolizumab. Beside its expected effect on circulating eosinophils, treatment with mepolizumab was associated with a significant reduction of annual rate of exacerbations and a reduced consumption of corticosteroids. We also observed a remission of lung lesions on follow-up HRCT.
In this open-label retrospective study, treatment of ICEP with mepolizumab was associated with a reduction of relapses, OCS use, and the disappearance of lung infiltrates.
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Idiopathic chronic hypereosinophilic pneumonia
High-resolution computed tomography
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Conflict of interest
The authors have no conflict of interest related to this manuscript.
The retrospective analysis of data from of patients who received mepolizumab for relapsing ICEP was approved by our ethical committee (study PNEU-ILD-02, approval number 2018/15MAR/116).
As this was a retrospective study, signed informed consent from patients was waived, according to local regulation.
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Brenard, E., Pilette, C., Dahlqvist, C. et al. Real-Life Study of Mepolizumab in Idiopathic Chronic Eosinophilic Pneumonia. Lung (2020). https://doi.org/10.1007/s00408-020-00336-3
- Idiopathic chronic eosinophilic pneumonia
- Interstitial lung diseases