Two large trials, DREAM and MENSA have found IL-5 therapy with mepolizumab to lower risk of exacerbation in patients with asthma with an eosinophilic phenotype. The studies had patients 12 years or older with asthma, at least two exacerbations requiring oral corticosteroids, and eosinophilic airway inflammation.
The rate ratio for reduction in exacerbations was 0.48 for patients with blood eosinophil count of 150cells/ul or higher to 0.30 for those with eosinophil count of 500cells/ul. Improvement in lung function was greater for avove the 500cells/ul threshold.
With the addition of new biologic agents, we can personalize care to our patients as we assess each phenotype of asthma. We provide Mepolizumab as well as Omalizumab injections in our office.