MEPOLIZUMAB FOR CHURG-STRAUSS SYNDROME

The Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis) is a rare systemic disease which can manifest with asthma, neuritis, renal impairment or fibrosing myocarditis, the latter two features being associated with a significant life-threatening potential. In this disease, conventional therapy represented by systemic cortico steroids or other immunosuppressor agents is usually associated with a variable therapeutic response, and therefore other approaches should be considered. One such approach is represented by the inhibition of a specific pathway resulting in upregulated eosinophilic inflammation. A relevant example in this respect is mepolizumab, a monoclonal anti-IL-5 antibody initially investigated for asthma and currently also evaluated for Churg-Strauss syndrome and eosinophilic esophagitis. In Churg-Strauss syndrome, mepolizumab would have the advantage of inhibiting eosinophilic inflammation at the systemic level, and in fact, in the few existing clinical studies it was found to induce a sustained eosinophil depletion. However, the long-term efficacy and safety should be further documented.