Steroid-sparing effect of mepolizumab in children with severe eosinophilic nonallergic asthma

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Maria Angela Tosca
Donata Girosi
Oliviero Sacco
Roberto Bernardini
Giorgio Ciprandi


bronchial endoscopy, children, eosinophils, mepolizumab, severe asthma


Background: Asthma is characterized by a chronic airway inflammation, usually sustained by type 2 immunity. Bronchial and peripheral eosinophilia are biomarkers for type 2 asthma. Biologicals are the most effective treatment for severe asthma at present. Mepolizumab is an antagonist of interleukin-5 (IL-5), the most relevant cytokine involved in eosinophilia.

Objective: This case report evaluated the effectiveness of mepolizumab in two girls with severe eosinophilic non-allergic asthma.

Materials and methods: Two female children with severe eosinophilic nonallergic asthma were treated with mepolizumab for two years. Clinical findings, lung function, peripheral eosinophils, asthma control, and bronchial endoscopy were performed.

Results: Biologicals reduced the eosinophilia, asthma exacerbations, and improved lung function in both patients. The treatment was also safe and well-tolerated.

Conclusion: Mepolizumab represents an effective therapeutic option in the management of severe pediatric asthma.

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