Most children with asthma respond to inhaled corticosteroids and other controller medicines. Still some children do not get optimal control despite these medicines. These children are said to have SEVERE ASTHMA. Children with severe asthma get daily symptoms of cough and breathlessness. Some children get repeated asthma attacks which might require emergency care and hospital admissions. Most children with severe asthma have poor lung function.
Till a few years back we did not have many medicines to treat severe asthma in children. Recently, a group of medicines known as biologicals are available for treatment of severe asthma in children. These medicines have significantly improved the quality of life of children with asthma. Many biologic medicines are approved and available for treatment of severe asthma in children. Omalizumab, mepolizumab, and dupilumab, are approved for children as young as 6 years, whereas benralizumab and tezepelumab are approved for adolescents older than 12 years. In this article we shall discuss the use of mepolizumab in children with severe asthma.
What is the mechanism of action of Mepolizumab?
Mepolizumab is a humanized, Interleukin-5 (IL-5) antagonist monoclonal antibody. IL-5 is a cytokine which regulates the growth, recruitment, activation, and life cycle of eosinophils. Eosinophils are considered to be the most important cells in asthma. Mepolizumab binds to IL-5 and inhibits IL-5 signaling thereby reducing eosinophil levels. This in turn reduces asthma attacks and asthma symptoms.
When is Mepolizumab indicated for children with severe asthma?
Mepolizumab is indicated for the treatment of severe asthma in children over 6 years of age with an eosinophilic phenotype.
What is the dose of Mepolizumab in children with severe asthma?
The recommended dosage of mepolizumab depends on the age of the child. In children aged 6–11 years mepolizumab is given as a subcutaneous injection at a dose of ambigram every 4 weeks. In children who are more than 12 years of age the doses are 100 mg subcutaneous injection every 4 weeks.
What are the side effects of Mepolizumab?
Mepolizumab is considered to be a very safe medicine without any serious side effects. Minor side effects include headache, injection site reactions (such as pain, redness, or swelling), back pain, and fatigue. Serious allergic reactions to Mepolizumab are known but uncommon and can include rashes, itching, urticaria, angioedema and anaphylaxis.
In case your child is having asthma which is not getting controlled with the usual medicines including inhalers you need to get in touch with the child pulmonologist for a proper evaluation and management.
