Nucala (mepolizumab) / GSK - LARVOL DELTA

Wells syndrome: emerging triggers and treatments- an updated systematic review. (PubMed, Arch Dermatol Res) - "Recent literature expands the clinical spectrum of Wells syndrome, highlighting new immunologic and iatrogenic triggers. Targeted treatments, especially biologics and Janus kinase inhibitors, demonstrate promising results and may offer steroid-sparing alternatives for patients with refractory disease. Clinicians should consider emerging triggers in differential diagnosis and evaluate newer therapies in recurrent or treatment-resistant cases. Further prospective and registry-based studies are warranted to validate efficacy and support development of evidence-based management guidelines."

Journal • Review • Dermatology • Infectious Disease • Influenza • Novel Coronavirus Disease • Oncology • Pediatrics • Respiratory Diseases

REAL-WORLD SAFETY AND EFFECTIVENESS OF MEPOLIZUMAB FOR PATIENTS WITH EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS IN JAPAN: A SUBGROUP ANALYSIS OF THE MARS STUDY (EULAR 2025) - P, P=N/A, P3 | "Patients with EGPA disease receiving high OCS dose (>7.5 mg/day) reported more AEs, more symptoms, and higher relapse rates than lower doses (<7.5 mg/day). Despite the duration of EGPA prior to mepolizumab treatment, ANCA-negative status, or immunosuppressant use at baseline, mepolizumab remains effective, though its impact on OCS reduction varied across subgroups. For relapse-free patients, continued mepolizumab use led to fewer AEs, lower OCS doses, and improved symptoms over time."

Clinical • Real-world • Real-world evidence • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Infectious Disease • Langerhans Cell Histiocytosis • Musculoskeletal Diseases • Orthopedics • Rare Diseases • Vasculitis

MEPOLIZUMAB 100 MG IN SEVERE ASTHMATIC PATIENTS WITH EGPA, LONG-TERM REAL-LIFE DATA (EULAR 2025) - "Mepolizumab in EGPA patients is associated with significant reductions in daily prednisone dosage and peripheral eosinophil count, giving a significant contribution to the remission of the disease. However, it may be insufficient for a minority of patients. The possibility of IS discontinuation over time might be influenced by the severity of the disease at presentation, even after adjustment for the current prednisone dose."

Clinical • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Respiratory Diseases • Vasculitis • IL5

Long-term effectiveness and safety of benralizumab in EGPA: a three-year monocentric experience (EULAR 2025) - "Primary objective was to assess disease remission (Birmingham Vasculitis Activity Score [BVASv3]=0 and prednisone≤4 mg/day), corticosteroid tapering, lung function, relapse, and discontinuation rates, with secondary endpoints on treatment failure and retention rates...Benralizumab was started on top of conventional immunosuppressants in 6 (7.8%) of the cases, the most commonly therapies prior to benralizumab were methotrexate (51.5%) and azathioprine (33.3%)...The main reason for treatment discontinuation was secondary failure, primarily driven by persistent and uncontrolled ENT/CRSwNP symptoms with 36.4% of patients switch to alternative therapies, primarily mepolizumab (300 mg) or dupilumab... These findings support the long-term effectiveness and safety of benralizumab for EGPA, highlighting its role in inducing clinical remission, reducing corticosteroid dependence and controlling disease activity. The limited response observed in patients with persistent ENT..."

Clinical • ANCA Vasculitis • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Nasal Polyps • Otorhinolaryngology • Rare Diseases • Respiratory Diseases • Sinusitis • Vasculitis • IL5

Recent glucocorticoid-sparing strategies lead to better prognosis for ANCA-associated vasculitis: Insights from the multicenter REVEAL cohort study (EULAR 2025) - "Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) continues to carry a poor prognosis, and its treatment has historically relied on glucocorticoids (GC) and cyclophosphamide, forcing patients to endure burdensome side effects, particularly infections. Recently, novel molecularly targeted therapies, including mepolizumab and avacopan, have been introduced... Although MPA remains associated with the highest mortality among AAV subtypes, the recent widespread adoption of GC-sparing strategies appears to have improved the overall prognosis of AAV."

Clinical • ANCA Vasculitis • Eosinophilic Granulomatosis With Polyangiitis • Infectious Disease • Langerhans Cell Histiocytosis • Rare Diseases • Vasculitis • CRP • MPO

Efficacy of Two Years of Treatment with Anti-IL-5/R Therapies According to Historic Disease Severity in Patients With Eosinophilic Granulomatosis with Polyangiitis (EULAR 2025) - P3 | "The 1-year double-blind period of the MANDARA trial (NCT04157348) demonstrated that benralizumab 1x30mg was non-inferior to mepolizumab 3x100mg (administered subcutaneously every 4 weeks) for achieving remission in patients with relapsing or refractory EGPA...The ‘severe EGPA group’ included patients with historic presence ever of at least one of the following: cardiomyopathy, glomerulonephritis, alveolar haemorrhage; or treatment with cyclophosphamide or rituximab... Anti-IL-5/R therapies demonstrated similar efficacy regarding remission, OGC use, and safety profiles in patients with EGPA regardless of history of severe disease. These data suggest a role for anti-IL-5/R therapies in the treatment pathway, even in patients with a history of severe EGPA manifestations, consistent with EULAR treatment guidelines [1]. The role of anti-IL-5/R therapies for treatment of active severe manifestations of EGPA requires further studies and pooled data from real-world studies..."

Clinical • Asthma • Cardiomyopathy • Cardiovascular • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Glomerulonephritis • Immunology • Inflammation • Langerhans Cell Histiocytosis • Lupus Nephritis • Nephrology • Rare Diseases • Respiratory Diseases • Vasculitis • IL5

Efficacy of Two Years of Treatment with Anti-IL-5/R Therapy for Achieving Glucocorticoid-Free Sustained Remission in Eosinophilic Granulomatosis with Polyangiitis (EULAR 2025) - P3 | " Following the double-blind period, patients could enter the open-label extension, during which they continued benralizumab (benra/benra) or switched from mepolizumab to benralizumab (mepo/benra)...Models were adjusted for baseline covariates, including baseline dose of prednisone, baseline BVAS and region... Over a third of patients with EGPA treated with anti-IL-5/R therapies for two years achieved a stringent definition of remission, characterised at the end of the two-year treatment period by no relapses, no active disease, and no requirement for OGCs. Despite complete withdrawal of OGCs, over 50% of patients experienced no relapses throughout the entire two years of treatment. These data suggest that discontinuation of OGCs while avoiding relapses is achievable with targeted anti-IL-5/R therapy and sets a new treatment goal."

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

IL-5 PATHWAY INHIBITORS DURING PREGNANCY IN EOSINOPHILIC DISORDERS: PRELIMINARY RESULTS OF A RETROSPECTIVE MULTICENTER STUDY (EULAR 2025) - " This retrospective, observational, multicenter study included adult women with a diagnosis of ED (i.e., EGPA, HES, EA or CRSwNP) treated with an IL-5i (mepolizumab, benralizumab, or reslizumab) during pregnancy. ED may represent a challenging condition in pregnancy, as uncontrolled disease and high GC use could seriously affect maternal and fetal outcomes. In our retrospective study, IL-5i have proven to be an effective treatment in pregnancy of ED patients, ensuring both persistent disease control and steroid sparing. No adverse events directly attributable to IL-5i treatment have been reported."

Retrospective data • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Diabetes • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Genetic Disorders • Gestational Diabetes • Hematological Disorders • Hypereosinophilic Syndrome • Immunology • Inflammatory Arthritis • Langerhans Cell Histiocytosis • Metabolic Disorders • Nasal Polyps • Otorhinolaryngology • Rare Diseases • Respiratory Diseases • Sinusitis • Small for Gestational Age • Vasculitis • IL5

QUANTITATIVE ANALYSIS OF MULTIPLE CYTOKINES IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS REVEALS DICHOTOMY IN EOSINOPHIL REGULATION: ROLE OF IL-25 AND IL-5 IN DISEASE SUBGROUPS (EULAR 2025) - "Eosinophilia is a hallmark feature of EGPA, and recently, mepolizumab (MPZ)—a monoclonal antibody targeting interleukin (IL)-5, which regulates eosinophil progenitor cell proliferation and activation—has been approved as a treatment option...Sera were analyzed before and 4 ± 2 weeks after initial treatment (mainly high-dose glucocorticoid with or without cyclophosphamide pulse therapy; n = 15), as well as before and 12 ± 4 weeks after MPZ treatment (n = 18)... Patients with EGPA did not exhibit a pronounced Th2 response compared with patients with SLE, except for IL-5. Th1 and Th17 responses were comparable between the patients with these diseases and strong correlations were observed between Th1 and Th17 cytokines. Quantification of various alarmins suggested that EGPA can be categorized into two subgroups—one in which eosinophil count is regulated by IL-25 and the other in which IL-25 is undetectable and eosinophil count is regulated by IL-5."

Asthma • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Inflammatory Arthritis • Langerhans Cell Histiocytosis • Oncology • Rare Diseases • Respiratory Diseases • Rheumatology • Vasculitis • CCL11 • CCL4 • CXCL8 • FGF • IFNG • IL10 • IL12A • IL13 • IL15 • IL17A • IL1B • IL1R1 • IL33 • IL4 • IL5 • IL6 • IL7 • IL9 • LGALS1 • MPO • TNFA • TSLP

Long-term treatment with low-dose mepolizumab for eosinophilic granulomatosis with polyangiitis: follow-up results from the European EGPA study group (EULAR 2025) - "Complete response to treatment was assessed up to 60 months after initiation of mepolizumab, and was defined as no disease activity (Birmingham Vasculitis Activity Score [BVAS] = 0) and a prednisolone or prednisone dose (or equivalent) of ≤4 mg/day, as reported in literature [1,4]. Long-term treatment with mepolizumab 100 mg/4 weeks appears effective and safe for EGPA. Switch to a higher dosage (300mg/4 weeks) might be required in patients inadequately controlled with low dosage."

Asthma • Endocrine Cancer • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Infectious Disease • Langerhans Cell Histiocytosis • Oncology • Prostate Cancer • Rare Diseases • Respiratory Diseases • Solid Tumor • Thyroid Gland Carcinoma • Vasculitis • IL5

Efficacy and Safety of Two Years of Treatment with Anti-IL-5/R Therapies for Eosinophilic Granulomatosis with Polyangiitis (EULAR 2025) - P3 | "In patients with EGPA receiving benralizumab, remission rates, discontinuation of OGC, and blood eosinophil count depletion were durable over 104 weeks with a low rate of relapse, low EGPA disease activity, and without loss of control of asthma or decline of lung function. Additional depletion of blood eosinophil count and OGC-sparing effects were observed in patients switching from mepolizumab to benralizumab. These data suggest that anti-IL-5/R therapies have enduring benefits in patients with relapsing/refractory EGPA."

Clinical • Asthma • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Infectious Disease • Langerhans Cell Histiocytosis • Novel Coronavirus Disease • Otorhinolaryngology • Rare Diseases • Respiratory Diseases • Sinusitis • Vasculitis • IL5

Inflammatory-Rheumatic Eosinophilic Myocarditis and its Critical Impact on Cardiac Function: Prognostic Value of NT-proBNP – Findings from a University Cohort (EULAR 2025) - "Induction therapy included glucocorticoids in all but one patient (median dosage 200 mg prednisone equivalent), cyclophosphamide (39%), benralizumab (9%), rituximab (6%), mepolizumab (3%), and other therapies (27%). For maintenance therapy glucocorticoids were utilized for all patients (median duration 34 months), with 48% also receiving benralizumab, 45% azathioprine, 42% mepolizumab, 21% methotrexate, 12% mycophenolate, and 36% other agents... Inflammatory-rheumatic EM has a significant impact on cardiac function. Despite high clinical remission rates and substantial improvement in cardiac laboratory parameters, half of the patients continue to exhibit reduced LVEF (< 50%) at follow-up. A trend toward LV dilation, which is linked to poorer cardiac prognosis, even in preserved LVEF, was observed."

Cardiovascular • Congestive Heart Failure • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Heart Failure • Hematological Disorders • Hypereosinophilic Syndrome • Inflammation • Langerhans Cell Histiocytosis • Rare Diseases • Rheumatology • Vasculitis

Th2-High Severe Asthma with Hypereosinophilia in the Spectrum of Type 2 Inflammatory Diseases. (PubMed, Int J Mol Sci) - "For instance, mepolizumab is approved for EGPA, HES, and chronic rhinosinusitis with nasal polyps, but its use in hypereosinophilic SA is limited by eligibility, tolerance, or effectiveness. SA with HE not classified as HES or EGPA is exceptionally rare and may be diagnosed by the exclusion of other potential causes of HE. This review analyzes recent studies and case reports, aiming to expand the understanding of this underrecognized clinical entity, its relation to T2 inflammation and eosinophilic disorders, and to highlight the need for improved diagnostic and therapeutic strategies."

Journal • Review • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Hematological Disorders • Hypereosinophilic Syndrome • Immunology • Inflammation • Langerhans Cell Histiocytosis • Nasal Polyps • Otorhinolaryngology • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Sinusitis • Vasculitis • IL5

A concurrence of eosinophilic esophagitis and eosinophilic gastritis in a patient with hypereosinophillia (EAACI 2025) - "The patient began mepolizumab May 2024 for hypereosinophilia as a bridge to dupilimab, however experienced increased dysphagia and food impaction symptoms with attempted partial food reintroduction. Dupilumab was started Aug 2024 with significant clinical improvement... This case highlights the challenges in distinguishing idiopathic hypereosinophilic syndrome with GI infiltration from EoE and EoG. It contributes to understanding the pathophysiology, natural history, and management of EGID disorders, including the impact of elemental diets and IL-5 inhibitors. The encouraging effectiveness of IL-4/IL-13 inhibitors may offer further insight into EGID mechanisms."

Clinical • Allergic Rhinitis • Atopic Dermatitis • Dermatitis • Immunology • Inflammation • IL13 • IL4 • IL5

Real-World Effectiveness of Dupilumab vs. Other Biologics in Achieving Clinical Remission as Assessed by a Composite Measure of Selected Asthma Outcomes in Patients with Severe Asthma: EU ADVANTAGE (EAACI 2025) - "We explored the real-world effectiveness of dupilumab in achieving selected components of clinical remission, compared with omalizumab, benralizumab, and mepolizumab in patients with SA across five European countries. These findings, based on selected components with available data, may introduce bias. Further studies exploring more rigorous remission criteria are recommended."

Clinical • Late-breaking abstract • Real-world • Real-world effectiveness • Real-world evidence • Immunology

Comparison of clinical outcomes with Benralizumab in severe eosinophilic asthma: Switched and naïve patients (EAACI 2025) - "Of the patients 10 (32.3%) had been switched from omalizumab or mepolizumab, while the remaining 21 (67.7%) patients were biologically naïve. These findings suggest that both biologic-naïve patients and patients who switched to benralizumab achieved comparable clinical improvements. The nearly complete depletion of eosinophils appears to play a key role in severe asthma control, regardless of prior biologic use, though long-term monitoring remains essential."

Clinical • Clinical data • Late-breaking abstract • Immunology • Inflammation

Biologic Therapy in Occupational Asthma: A Multicenter Retrospective Study on Treatment Outcomes and Occupational Impact (EAACI 2025) - "Results Nine patients were identified (5 from Germany, 2 from Italy, 2 from Ukraine), of whom 3 received benralizumab, while 2 each were treated with mepolizumab, dupilumab, and omalizumab. Further studies with larger cohorts are needed to establish clearer treatment guidelines. *IF and AH contributed equally to the study."

Retrospective data • Immunology • Inflammation

Differential effects of dupilumab in women with severe uncontrolled asthma (EAACI 2025) - "The most frequent change in women was from mepolizumab to dupilumab in 22 cases (51% of the total). In the effectiveness data at one year, there were significant differences in good+complete response (women 38.7%, men 70.5%, p<0.04), although not in clinical remission Conclusion We found differences between men and women in patients treated with dupilumab in clinical and functional parameters. The effectiveness at 12 months in terms of good + complete response is significantly lower in women, possibly conditioned by a lower frequency of concomitant polyposis, and not being a first-line treatment, so it is possible that these are more complex patients and a higher frequency of treatment failure with monoclonal agents previously."

Clinical • Immunology

Study of olfaction in patients with chronic rhinosinusitis with nasal polyposis undergoing Mepolizumab treatment (EAACI 2025) - "The initial mean QoL score on the SNOT-22 was 57.14 points, which improved to 38.14 points after one year (a difference of 19 points). Conclusion Olfactory dysfunction in patients with CRSwNP treated with mepolizumab, studied through olfactometry, shows improvements in olfactory parameters and QoL of the patients."

Clinical • Immunology • Inflammation

A one year, single centre, prospective study on EGPA patients treated with Mepolizumab (EAACI 2025) - "The BVAS score decreased from 20.30 at T0 before mepolizumab treatment to 11.25 after 12 months.OCS treatment from a total of 25.66 mg daily was reduced to 8.75 mg and 2.89 mg daily at 6 and 12 monthths respectively. Conclusion Mepolizumab 300 mg treatment for EGPA was effective in a one-year, real life study, on patients from a single centre, both p-ANCA positive and negative, in terms of reduced symptoms, blood eosinophils and OCS treatment dosages."

Clinical • Late-breaking abstract • Immunology • Vasculitis

Mepolizumab provides sustained clinical benefits in patients with severe asthma regardless of age of asthma onset: Real-world data from the REALITI-A study at 2 years (EAACI 2025) - "Conclusion This analysis demonstrates the sustained effectiveness of mepolizumab treatment in a real-world setting regardless of age of asthma onset. Numerically greater improvements were generally observed in patients with onset >18 years, although no correction was made for disease duration; further work is needed to elucidate the cause of this association."

Clinical • Late-breaking abstract • Real-world • Real-world evidence • Immunology • IL5

Combing dual biologics therapy for severe asthma : a series of ten cases (EAACI 2025) - "The biologic combinations are the following; mepolizumab + dupilumab (n=7), benralizumab + dupilumab (n=1), and omazulab + mepolizumab (n=2). Dual biologics are both effective and safe. However, more studies are needed to completely assess the long-term benefits and potential risks of different combinations of biologic treatments."

Clinical • Late-breaking abstract • Immunology • Inflammation

Real-Life Effectiveness of Monoclonal Antibody Therapy in Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyps: A Prospective Study (EAACI 2025) - "Results The cohort had a mean age of 52 years, with 63% male, 83% diagnosed with comorbid asthma, 50% with allergies, and 17% with aspirin intolerance...Conclusion This real-world study demonstrates the effectiveness of mepolizumab, omalizumab, and dupilumab as integral components of the treatment strategy for severe uncontrolled CRSwNP. These therapies significantly reduce nasal polyp burden, alleviate symptoms, and improve olfactory function and quality of life. The findings contribute valuable insights into the practical application and outcomes of type 2 inflammation-targeted therapies in real-life settings."

Clinical • Immunology • Inflammation

Redefining STAT5B N642H Gain of function Mutation: Unique Phenotypic Features and First Successful Mepolizumab Treatment in a Pediatric Case (EAACI 2025) - "He was managed initially with prednisone 4mg/kg/day tapered based on clinical response then shifted to IL-5 antagonist monoclonal antibody Mepolizumab 100mcg monthly. It also showed for the first time that Mepolizumab controls disease activity. Expanding knowledge about STAT5B mutations will contribute to improved recognition, management, and potentially targeted therapies for affected patients."

Clinical • Atopic Dermatitis • Dermatitis • Food Hypersensitivity • Immunology • IL5 • STAT5B

Distribution of Baseline Type 2 Inflammation Characteristics in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) Biologic Clinical Trials: A Comparative Assessment (EAACI 2025) - P3 | "Patients from the SINUS-24/52 (dupilumab, anti-interleukin [IL]-4Rα), POLYP-1/2 (omalizumab, anti-IgE), SYNAPSE (mepolizumab, anti-IL-5), and OSTRO (benralizumab, anti-IL-5Rα) trials were included, as well as patients from the replicate Phase III ANCHOR-1/2 trials. ANCHOR-1/2 investigated the efficacy and safety of depemokimab (ultra-long-acting anti-IL-5 administered twice yearly) versus placebo...These differences may have been driven by factors including distinct geographic footprints, or biologic availability during the later trials. Patients with CRSwNP and biomarkers of type 2 inflammation have greater disease burden and comprise a more biologic-treatment responsive population; the proportion of such patients at baseline should be considered when interpreting outcomes from clinical studies of biologics in CRSwNP."

Clinical • Immunology • Inflammation • IL5