Mepolizumab and Blood Eosinophil Variability in COPD: A New Dimension in Targeted Therapy

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This article summarizes pooled data from three Phase 3 trials demonstrating that mepolizumab reduces COPD exacerbations in patients with elevated blood eosinophil counts (BEC), regardless of whether these elevations are persistent or variable over time. Benefits were observed in exacerbation reduction including those requiring emergency care or hospitalization, while patients with persistently low BECs (<150 cells/µL) showed no therapeutic advantage. This finding challenges the notion that persistent eosinophilia is required for selecting eligible patients and supports a broader identification of treatable eosinophilic COPD phenotypes.

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