Mepolizumab Efficacy in COPD: Insights from Longitudinal Patterns of Blood Eosinophil Counts and Their Variability Across Three Clinical Trials

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Key Points

This research aims to assess the efficacy of mepolizumab in reducing exacerbations in COPD patients based on blood eosinophil count variability.
Data pooled from Phase 3, randomized, double-blind, placebo-controlled trials: METREX, METREO, and MATINEE.
Patients received mepolizumab 100 mg or placebo, and their historical blood eosinophil counts were documented.
Outcomes included annualized rates of moderate/severe exacerbations and those requiring emergency visits/hospitalization.
Mepolizumab reduced annualized rates of moderate/severe exacerbations by 21% in patients with BEC ≥ 300 cells/µL.
Reduction was also seen in patients with persistently elevated BEC (12-27%) and variable BEC (22-36%).
No benefit observed with mepolizumab in patients with persistently low BEC (<150 cells/µL).

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Randomized trial evaluates mepolizumab efficacy in COPD, highlighting association with eosinophil patterns.

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Criner et al. (2026) studied this question.

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