Nucala (mepolizumab) / GSK - LARVOL DELTA

Therapeutic Switching of Biological Drugs in Paediatric Severe Asthma: Experience of a Referral Centre. (PubMed, Biomedicines) - "Switching occurred from omalizumab to dupilumab (n = 1), mepolizumab to dupilumab (n = 5), and mepolizumab to omalizumab (n = 2)...The daily fluticasone-equivalent dose decreased from a median of 500 μg to 425 μg...These findings highlight the importance of close clinical and functional monitoring to identify children who may benefit from a change in biologic therapy. Larger prospective studies are needed to define standardized criteria and optimal timing for biologic switching in pediatric severe asthma."

Journal • Asthma • Immunology • Pediatrics • Pulmonary Disease • Respiratory Diseases

New advances in the treatment of chronic rhinosinusitis with nasal polyps from pathophysiology to biologic targeted therapy. (PubMed, Front Allergy) - "Biologics including dupilumab (anti-IL-4Rα), mepolizumab (anti-IL-5), omalizumab (anti-IgE) and tezepelumab (anti-TSLP) can precisely target key molecules in type 2 inflammatory pathways, achieving effective and long-lasting disease control, reducing polyp volume, improving nasal symptoms and olfactory function, decreasing reliance on oral corticosteroids and the need for reoperation, and exerting synergistic effects on comorbid asthma. Future research will focus on predictive biomarkers, head-to-head comparative studies and new targets for non-type 2 inflammation to optimize long-term management. By integrating recent biologic evidence with endotype-based recurrence mechanisms, this review provides a practical framework for biologic stewardship and remission-oriented management in CRSwNP."

Journal • Review • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Immunology • Inflammation • Nasal Polyps • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • Sinusitis • IL13 • IL4 • IL5

Ocular Safety of Dupilumab Compared With IL-5 Inhibitors in Asthma. (PubMed, J Allergy Clin Immunol Pract) - "Dupilumab was associated with a modestly higher, but overall infrequent, risk of OAEs than IL-5 inhibitors in asthma over 6 months (2.6% vs 2.1%), a rate substantially lower than the 8-28% previously reported in AD populations. This risk, driven primarily by conjunctivitis, was most pronounced among younger adults, men, and patients with comorbid AD, suggesting that AD may also contribute to this adverse effect. Continued ocular monitoring is warranted, particularly in these subgroups."

Journal • Allergic Rhinitis • Asthma • Conjunctivitis • Dermatitis • Dermatology • Dry Eye Disease • Immunology • Inflammation • Ocular Infections • Ocular Inflammation • Ophthalmology • Pulmonary Disease • Respiratory Diseases • IL5

Update on biologic and small molecules treatments in pediatric allergic diseases. (PubMed, Pediatr Allergy Immunol) - "The pioneer anti-IgE monoclonal antibody, omalizumab, was initially indicated for the treatment of moderate to severe allergic asthma and is now indicated for chronic spontaneous urticaria (CSU), chronic rhinosinusitis with nasal polyps (CRSwNP), and food allergy (FA), highlighting the ability of biologics to target multiple allergic diseases. Other biologics have been developed in asthma and other allergic diseases, including mepolizumab (anti-IL5), benralizumab (anti-IL5 receptor), dupilumab (anti-IL-4 receptor α), and more recently tezepelumab (anti-TSLP)...In the long term, the sustained efficacy, safety and impact on the natural history of allergic diseases need to be further studied. The aim of this review is to discuss the most recent data in the use of biologics and small molecules in pediatric allergic diseases and to highlight the remaining gaps in knowledge."

Journal • Review • Allergy • Asthma • Atopic Dermatitis • Chronic Rhinosinusitis With Nasal Polyps • Chronic Spontaneous Urticaria • Dermatitis • Dermatology • Eosinophilic Esophagitis • Food Hypersensitivity • Gastrointestinal Disorder • Immunology • Nasal Polyps • Otorhinolaryngology • Pediatrics • Pulmonary Disease • Respiratory Diseases • Sinusitis • Urticaria • IL4 • IL5

Real-World Effectiveness of Mepolizumab Initiation in Treating Asthma and Concurrent Chronic Obstructive Pulmonary Disease in the US. (PubMed, Pulm Ther) - "In this analysis of a large US claims database, mepolizumab reduced exacerbations and overall disease burden in patients with asthma and concurrent COPD."

Journal • Real-world evidence • Asthma • Chronic Obstructive Pulmonary Disease • Immunology • Pulmonary Disease • Respiratory Diseases

Idiopathic Hypereosinophilic Syndrome (HES) Presenting With Weight Loss and Dyspepsia (ACG 2026) - "Following initiation of mepolizumab, the patientâs absolute eosinophilic count showed remarkable improvement, decreasing from 1.9 x 10^3/µL on January 22 nd 2026 to 0.2 x 10^3/µL on May 7 th 2026...Our case highlights the importance of evaluating eosinophils on stomach biopsies to aid in diagnosing HES. Figure: A) Gastric antral mucosa with innumerable Eosinophils (10X) B) Gastric oxyntic mucosa with Eosinophils (20X)"

Anorexia • Dyspepsia • Eosinophilia • Eosinophilic Esophagitis • Gastrointestinal Disorder • Hematological Malignancies • Hypereosinophilic Syndrome • Immunology • Infectious Disease • Rare Diseases • PDGFRA

Gut Feeling: Dupilumab Resolves Gastrointestinal Manifestations of Hypereosinophilic Syndrome Despite Persistent Peripheral Eosinophilia (ACG 2026) - "Prednisone led to clinical improvement, but symptoms recurred post-taper...Mepolizumab and hydroxyurea were initiated which reduced the eosinophil count...Figure: Prominent eosinophilic infiltration in the lamina propria in gastric oxyntic mucosa (up to 86 in one high-power field) improved from initial presentation. Figure: Peripheral eosinophil counts throughout the patient's clinical course and treatment transitions."

Asthma • Eosinophilia • Eosinophilic Esophagitis • Gastroenterology • Gastrointestinal Disorder • Hypereosinophilic Syndrome • Immunology • Infectious Disease • Inflammation • Respiratory Diseases • FIP1L1 • IL13 • IL4 • IL5 • PDGFRA

Hypereosinophilic Syndrome Presenting as an Eosinophilic Esophagitis and Achalasia Mimicker (ACG 2026) - "Case Description/ A 67-year-old man with history of Merkel cell carcinoma (treated with nivolumab) presented with dysphagia...He started dupilumab and underwent EGD 2 months later...For idiopathic HES, mepolizumab is often used with success, as seen in our patient...Figure: High resolution esophageal manometry showed normal lower esophageal pressure with incomplete relaxation. Esophageal body shows no peristalsis and pan esophageal pressurization consistent with possible type II achalasia."

Eosinophilia • Eosinophilic Esophagitis • Gastrointestinal Disorder • Hematological Disorders • Hypereosinophilic Syndrome • Immunology • Merkel Cell Carcinoma • Non-melanoma Skin Cancer • Rare Diseases • Skin Cancer • Solid Tumor • IL5

Biologic Therapy for Non-Eosinophilic-Esophagitis Eosinophilic Gastrointestinal Disease: A Scoping Review of the Patient-Level Literature (ACG 2026) - "Other agents were Mepolizumab (n=7), Vedolizumab (n=6), Benralizumab (n=2), and omalizumab (n=1)...In only RCT, lirentelimab achieved histologic but not symptomatic response... 22 articles were included: 19 patient level case reports and series, 1 phase 2 RCT (ENIGMA) and 2 retrospective cohort reports, all contributed 36 cases. Pure non-EoE patients (n=14) tended to be older (median 34 years, IQR 16-50), more female 9 (64%) and less pediatric 4 (29%) than EoE overlap patients (n=22, median 16 years, IQR 11-24), more frequently male and more pediatric 14 (64%). Dupilumab was predominant agent (20/36, 56%), used more in EoE Overlap (n=15, 68%) than pure non-EoE (n=5, 36%)."

Clinical • Review • Asthma • Eosinophilic Esophagitis • Gastroenterology • Gastrointestinal Disorder • Immunology • Respiratory Diseases • IL5

Dose-Response and Time-Course Dynamics of Biologics in Eosinophilic Esophagitis: A Model-Based Network Meta-Analysis (ACG 2026) - "Sixteen trial arms across seven classes (dupilumab, cendakimab, mepolizumab, budesonide orodispersible tablet, fluticasone, proton pump inhibitors, and reslizumab) were analyzed. Dupilumab dose-response modeling revealed Emax 88.6%, ED50 1.0 mg, and γ 0.10, indicating near-maximal efficacy at clinical doses with limited gain beyond 100 mg. Increasing from 100 to 300 mg added only 2.3% additional response. Time-course modeling (300 mg weekly) estimated ET50 17.8 weeks, with predicted remission rates of 36% (week 8), 45% (week 12), 62% (week 24), and 80% (week 52), closely matching observed trial data (week 24: 59-60%; week 52: 84.6%)."

Retrospective data • Eosinophilic Esophagitis • Gastrointestinal Disorder • Immunology

Risk of Respiratory Tract Infections with Asthma Biologics. (PubMed, J Allergy Clin Immunol Pract) - "Although further studies focusing on specific pathogens and pathways are needed, asthma biologics are not associated with a higher risk of respiratory infections. Dupilumab might reduce the risk of certain respiratory tract infections."

Journal • Asthma • Immunology • Infectious Disease • Influenza • Otorhinolaryngology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sinusitis • IL5

Mepolizumab Cuts COPD Exacerbations Across Smoking Status: Claus Vogelmeier, MD (HCPLive) - "A pooled analysis of the phase 3 METREX, METREO, and MATINEE trials found that mepolizumab (GSK) reduced moderate or severe exacerbations in patients with eosinophilic chronic obstructive pulmonary disease (COPD) regardless of whether they were current or former smokers, though the drug's benefit on more serious outcomes appeared limited to former smokers...the pooled analysis, presented at the 2026 European Respiratory Society (ERS) Congress....The analysis stratified patients by smoking status and by blood eosinophil count (BEC) at screening (≥150 cells/µL or ≥300 cells/µL). Mepolizumab significantly reduced annualized moderate/severe exacerbations versus placebo in former smokers by 19% (BEC ≥150 cells/µL) and 25% (BEC ≥300 cells/µL), and in current smokers by 23% (BEC ≥150 cells/µL) and 18% (BEC ≥300 cells/µL, not statistically significant)."

Retrospective data • Chronic Obstructive Pulmonary Disease • Immunology

Immunopathogenic Endotypes of Asthma: From Type 2 and Non-Type 2 Inflammation to Precision Therapeutic Strategies. (PubMed, J Asthma) - "Depending on type of inflammation, eosinophilic (anti-IL-5 (mepolizumab) and mixed inflammation (dupilumab/tezepelumab) and high IgE (omalizumab) biomarkers are pivotal in stratifying phenotypes, predicting exacerbation, and informing targeted biologics, including anti-IL-5 (mepolizumab) and dupilumab/tezepelumab, respectively. This synthesis heralds a paradigm shift of empirical symptom control to personalized interventions, reduction of exacerbations, lessening of overtreatment, and the identification of new targets in multi-omics era to overcome the unmet needs of severe, steroid-resistant asthma."

Journal • Review • Allergy • Asthma • Immunology • Inflammation • Oncology • Pulmonary Disease • Respiratory Diseases • IL33 • IL4 • IL5

Updates in COPD Management: From Inflammatory Pathways to Targeted Therapies. (PubMed, Eur J Clin Invest) - "COPD management is evolving toward precision medicine, guided by inflammatory phenotypes, biomarkers, and individualised risk profiles. Continued investigation into targeted biologics, anti-inflammatory agents, and incorporating biomarkers into clinical practice may improve outcomes and reduce disease burden."

Biomarker • Journal • Review • Cardiovascular • Chronic Obstructive Pulmonary Disease • Cognitive Disorders • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases • IL33

Influence of newly initiated biologic therapy on the dose of ICS therapy - Data from the German Asthma Net. (PubMed, J Allergy Clin Immunol Pract) - "ICS reduction was associated with improved patient-reported outcomes without worsening exacerbations, lung function or FeNO."

Journal • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Early Treatment Pathways Improve Outcomes in Severe Autoimmune Diseases: Systematic Review and Evidence Synthesis of 430 Studies (ACR Convergence 2026) - "Rituximab maintenance therapy significantly reduced relapse compared with azathioprine (HR 0.36, 95% CI 0.23-0.57), while avacopan-based protocols achieved sustained remission in 71.0% versus 56.1% of patients receiving conventional glucocorticoid regimens (difference 12.5%, 95% CI 2.6-22.3; p=0.007). In EGPA, mepolizumab significantly increased remission rates (OR 12.0, 95% CI 2.7-53.0). In SSc-ILD, nintedanib reduced annual forced vital capacity decline by 41 mL/year and multiple trials demonstrated preservation of pulmonary function with cyclophosphamide-, mycophenolate-, and tocilizumab-based treatment protocols. In SLE, anifrolumab improved BICLA response rates versus placebo (59.4% vs 43.9%; p=0.02), while lupus nephritis studies demonstrated significant reductions in adverse renal outcomes (HR 0.12, 95% CI 0.031-0.39).Overall, evidence supporting morbidity reduction (184 studies) exceeded evidence for mortality reduction (122 studies), indicating that prevention..."

Review • ANCA Vasculitis • Dermatomyositis • Eosinophilic Granulomatosis With Polyangiitis • Glomerulonephritis • Immunology • Inflammatory Arthritis • Interstitial Lung Disease • Langerhans Cell Histiocytosis • Lupus • Lupus Nephritis • Myositis • Nephrology • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Scleroderma • Systemic Sclerosis • Vasculitis • IFIH1

Real-World Patient Perspectives on Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis (EGPA): Treatment Satisfaction, Quality of Life Benefits, and the Continuing Burden of Injections (ACR Convergence 2026) - No abstract available

Clinical • HEOR • Real-world • Real-world evidence • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Vasculitis

Real-World Efficacy of Mepolizumab as First-Line Therapy for eosinophilic granulomatosis with polyangiitis (EGPA): A Retrospective Cohort study by the European EGPA Study Group (ACR Convergence 2026) - No abstract available

Real-world • Real-world effectiveness • Real-world evidence • Retrospective data • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Vasculitis

Switching From Mepolizumab to Benralizumab After Glucocorticoid-Free Remission in EGPA: A Single-Center Observational Study (ACR Convergence 2026) - No abstract available

Clinical • Observational data • Vasculitis

Remission and Glucocorticoid Sparing With Mepolizumab and Benralizumab in Eosinophilic Granulomatosis With Polyangiitis: A Systematic Review of Randomized and Real-World Evidence. (ACR Convergence 2026) - No abstract available

Clinical • HEOR • Real-world • Real-world evidence • Review • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Vasculitis

Mepolizumab versus Conventional Therapy for Remission Induction in Eosinophilic Granulomatosis with Polyangiitis: Results from the Double-Blind, Double-Dummy, Randomized Controlled E-MERGE Trial (ACR Convergence 2026) - "The primary endpoint was remission at day 168, defined as a BVAS of 0, prednisone ≤4 mg/day, and no vasculitic relapse. In patients with newly diagnosed or relapsing EGPA, early mepolizumab treatment did not significantly improve remission by day 168 compared to conventional therapy. However, it did significantly increase sustained remission, glucocorticoid-free remission and EGPA-related event-free survival over one year. These results support the use of earlier IL-5 blockade in patients with newly diagnosed or active EGPA."

Clinical • Asthma • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Respiratory Diseases • Vasculitis • IL5

Prescribing characteristics of asthma biologics used in an adult cystic fibrosis clinic (NACFC 2026) - "The most common initial biologic used was dupilumab with 25 patients initiated on this, with 5 started on benralizumab, 3 on omalizumab and 1 on mepolizumab. Given their favorable safety data, the potential risks of inhaled steroids in cystic fibrosis, and the high prevalence of asthma and T2 inflammation in cystic fibrosis, asthma biologics represent an attractive treatment option in cystic fibrosis. More research is needed, however, to determine their safety, efficacy and the optimal biomarkers to predict response in cystic fibrosis."

Clinical • Allergic Bronchopulmonary Aspergillosis • Asthma • Atopic Dermatitis • Chronic Obstructive Pulmonary Disease • Cystic Fibrosis • Eosinophilic Esophagitis • Gastrointestinal Disorder • Genetic Disorders • Immunology • Inflammation • Nasal Polyps • Otorhinolaryngology • Pruritus • Pulmonary Disease • Respiratory Diseases • Sinusitis

Real-world effectiveness of T2-targeted biologics in patients with chronic obstructive pulmonary disease (COPD) (ERS 2026) - " This retrospective, monocentric study at Foch Hospital included COPD patientstreated for ≥ 3 months with Th2-targeted biologics (benralizumab, dupilumab, mepolizumab,omalizumab, or tezepelumab) between 2018 and 2025. T2-targeted biologics significantly reduce exacerbation frequency and OCS usein COPD patients, regardless of an associated asthma phenotype."

Clinical • Real-world • Real-world effectiveness • Real-world evidence • Asthma • Chronic Obstructive Pulmonary Disease • Pulmonary Disease • Respiratory Diseases

Eligibility for biological treatments in COPD patients experiencing a severe COPD exacerbation (ERS 2026) - " In this single center retrospective study, we evaluated the eligibility of COPD patients hospitalized during the last 6 years in the respiratory department of a tertiary hospital for a severe COPD exacerbation, to receive either dupilumab or mepolizumab according to the inclusion criteria of their respective randomized controlled trials and GOLD 2026 recommendations. Only a minority of patients hospitalized due to severe COPD exacerbation would have been eligible to receive biologic therapy. Optimization of medical treatment including inhaled medication in addition to disease phenotyping are pivotal for the recognition of the patients which will benefit from the use of biologics."

Clinical • Asthma • Cardiovascular • Chronic Obstructive Pulmonary Disease • Immunology • Inflammation • Respiratory Diseases

Beyond Type 2 Inflammation: How Obesity Impacts Clinical Remission in Biologic-Treated Severe Asthma (ERS 2026) - " Eighty-two SA patients prospectively enrolled and treated with biologics were included (benralizumab n=29, 35.4%; dupilumab n=30, 36.6%; mepolizumab n=16, 19.5%; tezepelumab n=7, 8.5%). Higher baseline BMI was associated with a reduced likelihood of clinical remission in biologic-treated SA, despite comparable modulation of T2 biomarkers, suggesting the involvement of non-T2 mechanisms."

Clinical • Asthma • Genetic Disorders • Immunology • Inflammation • Obesity • Respiratory Diseases