INTERLEUKIN-5 IS A NEW TARGET IN THE TREATMENT OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

Abstract

Interleukin-5 (IL-5) is involved in the maturation and activation of eosinophils, its production is increased in patients with eosinophilic granulomatosis with polyangiitis (EGPA). This rare form of systemic vasculitides (SV) is characterized by peripheral eosinophilia and involves multiple organs and systems. The clinical introduction of glucocorticoids (GCs) and immunosuppressants has considerably improved the prognosis of EGPA, but their use is associated with significant adverse reactions and cannot be effective enough. The use of standard treatment regimens cannot always allow to achieve remission; the rate of EGPA relapses remains high. Mepolizumab is an IL-5 antagonist and a promising drug for the treatment of patients with EGPA. The presented literature review considers arguments in favor of using mepolizumab in EGPA patients and discusses its efficacy and safety. The currently accumulated data suggest that mepolizumab is effective and safe in treating patients with EGPA, what has been demonstrated in the registration double-blind, randomized, placebo-controlled MIRRA study. Treatment with the IL-5 antagonist allows one to control both the symptoms of asthma and the manifestations of SV, enhances the probability of achieving remission of EGPA, can help reduce the risk of relapse and minimize the dose of GS.