Severe Asthma

What is Mepolizumab?

An anti-IL-5 monoclonal antibody that dramatically reduces exacerbations in severe eosinophilic asthma, COPD with eosinophilia, EGPA (Churg-Strauss), and hypereosinophilic syndrome. It targets the master regulator of eosinophil production.

Why China?

• Cost (annual): $6,000-$12,000 vs. $30,000-$45,000 in the US
• Biologics available: Mepolizumab, benralizumab, omalizumab all NMPA-approved
• Severe asthma centers: West China, Zhongshan, PUMC — specialized units
• Combination approach: Optimize inhaler technique + comorbidity management before escalating

Who is a candidate?

• Severe eosinophilic asthma (≥150 eos/μL, recurrent exacerbations despite high-dose ICS/LABA)
• Prednisone-dependent asthma
• EGPA (Churg-Strauss)
• Hypereosinophilic syndrome

Outcomes

Exacerbation reduction: 50-60%. Oral steroid reduction: 50-75%. Asthma control score improvement: clinically significant in 60-70%. Maintenance of response: durable with continued therapy.