Mepolizumab Reduced Corticosteroid Use in COPD Patients - Respiratory Therapy

In pooled phase 3 data, mepolizumab lowered mean yearly systemic corticosteroid exposure by 178.97 mg in patients with a BEC of ≥150 cells/µL. Mepolizumab (Nucala) reduced total yearly systemic corticosteroid (SCS) exposure, particularly high-dose courses, in patients with COPD and type 2 inflammation receiving inhaled triple therapy, according to pooled phase 3 data presented at the American College of Chest Physicians (CHEST) 2026 Annual Meeting in Phoenix.¹,²Although treatment guidelines recommend SCS for COPD exacerbations, these agents are associated with complications in this population, prompting interest in targeted therapies capable of limiting their use.¹ Mepolizumab, a humanized monoclonal antibody targeting interleukin-5 (IL-5), is approved for patients with COPD and an eosinophilic phenotype.

Conflicts of interest: Carlin has received conference travel, speaker fees, advisory board, unrestricted investigator-initiated grant, and joint working support from AstraZeneca, Glaxo-Smith Kline, Sanofi-Regeneron, and ResMed. Keywords: Case-finding, COPD, diagnosis, exacerbations, lung cancer screening.

David Mannino | Professor, University of Kentucky College of Medicine, Lexington, USA; Chief Medical Officer, COPD Foundation Could you tell us what first drew you to respiratory medicine and COPD, and how this interest has developed throughout your career?

Patients with asthma and chronic obstructive pulmonary disease (COPD) often receive systemic corticosteroids from multiple specialties, and that cumulative exposure is rarely tracked in 1 place. At the same time, the options for reducing reliance on oral steroids have grown, with approvals of dupilumab and mepolizumab for eosinophilic COPD and of depemokimab, a twice-yearly anti-interleukin (IL)-5 agent, for severe asthma.1-4 Clinicians outside pulmonology increasingly manage these patients when specialty access is limited. On October 6, 2026, Mollie Chartoff, FNP-BC, a nurse practitioner on the advanced COPD team at Vanderbilt Lung Institute in Nashville, Tennessee, moderated a virtual clinical forum for advanced practice providers on asthma and COPD. Participants included nurse practitioners and physician assistants in pulmonology, allergy and asthma, dermatology, oncology, and interventional pain practices in Tennessee, Texas, Missouri, and North Carolina. The discussion covered biomarkers, oral corticosteroid (OCS) exposure, biologic selection, and access barriers.