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Real-Life Study of Mepolizumab in Idiopathic Chronic Eosinophilic Pneumonia

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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


Oral corticosteroids


  1. 1.

    Allen J, Wert M (2018) Eosinophilic pneumonias. J Allergy Clin Immunol Pract 6(5):1455–1461.

  2. 2.

    Marchand E, Cordier JF (2006) Idiopathic chronic eosinophilic pneumonia. Semin Respir Crit Care Med 27(2):134–141.

  3. 3.

    Hayakawa H, Sato A, Toyoshima M, Imokawa S, Taniguchi M (1994) A clinical study of idiopathic eosinophilic pneumonia. Chest 105(5):1462–1466.

  4. 4.

    Marchand E, Reynaud-Gaubert M, Lauque D, Durieu J, Tonnel AB, Cordier JF (1998) Idiopathic chronic eosinophilic pneumonia a clinical and follow-up study of 62 cases The Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P). Medicine (Baltimore) 77(5):299–312.

  5. 5.

    Sullivan PW, Ghushchyan VH, Globe G, Schatz M (2018) Oral corticosteroid exposure and adverse effects in asthmatic patients. J Allergy Clin Immunol 141(1):110–116.

  6. 6.

    Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, Humbert M, Katz LE, Keene ON, Yancey SW, Chanez P (2014) Mepolizumab treatment in patients with severe eosinophilic asthma. N. Engl J Med.

  7. 7.

    Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON, Yancey SW, Ortega HG, Pavord ID, Investigators S (2014) Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med 371(13):1189–1197.

  8. 8.

    Steinfeld J, Bradford ES, Brown J, Mallett S, Yancey SW, Akuthota P, Cid MC, Gleich GJ, Jayne D, Khoury P, Langford CA, Merkel PA, Moosig F, Specks U, Weller PF, Wechsler ME (2019) Evaluation of clinical benefit from treatment with mepolizumab for patients with eosinophilic granulomatosis with polyangiitis. J Allergy Clin Immunol 143(6):2170–2177.

  9. 9.

    Roufosse FE, Kahn JE, Gleich GJ, Schwartz LB, Singh AD, Rosenwasser LJ, Denburg JA, Ring J, Rothenberg ME, Sheikh J, Haig AE, Mallett SA, Templeton DN, Ortega HG, Klion AD (2013) Long-term safety of mepolizumab for the treatment of hypereosinophilic syndromes. J Allergy Clin Immunol 131(2):461–467.

  10. 10.

    To M, Kono Y, Yamawaki S, Soeda S, Katsube O, Kishi H, To Y (2018) A case of chronic eosinophilic pneumonia successfully treated with mepolizumab. J Allergy Clin Immunol Pract 6(5):1746–1748.

  11. 11.

    Rothenberg ME, Klion AD, Roufosse FE, Kahn JE, Weller PF, Simon HU, Schwartz LB, Rosenwasser LJ, Ring J, Griffin EF, Haig AE, Frewer PI, Parkin JM, Gleich GJ, Mepolizumab HESSG (2008) Treatment of patients with the hypereosinophilic syndrome with mepolizumab. N Engl J Med 358(12):1215–1228.

  12. 12.

    Suzuki Y, Suda T (2019) Eosinophilic pneumonia: a review of the previous literature, causes, diagnosis, and management. Allergol Int 68(4):413–419.

  13. 13.

    Judson MA, Chaudhry H, Louis A, Lee K, Yucel R (2015) The effect of corticosteroids on quality of life in a sarcoidosis clinic: the results of a propensity analysis. Respir Med 109(4):526–531.

  14. 14.

    Nureki S, Miyazaki E, Ishi T, Ito T, Takenaka R, Ando M, Kumamoto T (2013) Elevated concentrations of CCR7 ligands in patients with eosinophilic pneumonia. Allergy.

  15. 15.

    Kuang FL, Legrand F, Makiya M, Ware J, Wetzler L, Brown T, Magee T, Piligian B, Yoon P, Ellis JH, Sun X, Panch SR, Powers A, Alao H, Kumar S, Quezado M, Yan L, Lee N, Kolbeck R, Newbold P, Goldman M, Fay MP, Khoury P, Maric I, Klion AD (2019) Benralizumab for PDGFRA-Negative hypereosinophilic syndrome. N Engl J Med 380(14):1336–1346.

  16. 16.

    Ortega H, Lemiere C, Llanos JP, Forshag M, Price R, Albers F, Yancey S, Castro M (2019) Outcomes following mepolizumab treatment discontinuation: real-world experience from an open-label trial. Allergy Asthma Clin Immunol 15:37.

  17. 17.

    McQueen RB, Sheehan DN, Whittington MD, van Boven JFM, Campbell JD (2018) Cost-Effectiveness of biological asthma treatments: a systematic review and recommendations for future economic evaluations. Pharmacoeconomics 36(8):957–971.

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Author information

Correspondence to Antoine Froidure.

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Conflict of interest

The authors have no conflict of interest related to this manuscript.

Ethical Approval

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).

Informed Consent

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).

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  • Idiopathic chronic eosinophilic pneumonia
  • Mepolizumab
  • Interstitial lung diseases