Efficacy without resolution: A critical appraisal of mepolizumab in eosinophilic COPD

Mario Cazzola; Maria Gabriella Matera

doi:10.1016/j.medj.2025.100784

Efficacy without resolution: A critical appraisal of mepolizumab in eosinophilic COPD

Med. 2025 Aug 8;6(8):100784. doi: 10.1016/j.medj.2025.100784.

Authors

Mario Cazzola¹, Maria Gabriella Matera²

Affiliations

¹ Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy. Electronic address: mario.cazzola@uniroma2.it.
² Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

PMID: 40782669
DOI: 10.1016/j.medj.2025.100784

Abstract

Mepolizumab reduces exacerbations in eosinophilic COPD but shows limited effects on symptoms, lung function, or quality of life. The MATINEE trial supports a precision medicine approach targeting high blood eosinophil counts.¹ However, IL-5 blockade alone may be insufficient due to complex, overlapping inflammatory pathways and persistent lung-resident eosinophils.

Publication types

Review

MeSH terms

Antibodies, Monoclonal, Humanized* / therapeutic use
Eosinophilia* / drug therapy
Eosinophils
Humans
Interleukin-5 / antagonists & inhibitors
Precision Medicine
Pulmonary Disease, Chronic Obstructive* / drug therapy
Pulmonary Disease, Chronic Obstructive* / physiopathology
Pulmonary Eosinophilia* / drug therapy
Quality of Life
Treatment Outcome

Substances

mepolizumab
Antibodies, Monoclonal, Humanized
Interleukin-5