Dear Dr. K: What can you tell me about the new asthma drug, Nucala?
It is just newly released by the FDA, seems very promising; unfortunately, it is not for you.
Because I’ve helped you with your asthma for several years, I am aware that you don’t have eosinophilic asthma, and thus, would not be a candidate for this new drug.
Nucala’s pharmacologic name is mepolizumab is a monoclonal antibody whose target is interleukin–5 (IL\-5). It is delivered in a subcutaneous injection that is given once a month in a doctor’s office. It is designed for severe asthmatics aged 12 years or older, who have the eosinophilic type of asthma.
IL-5 is the main cytokine responsible for growth, recruitment, activation and survival of eosinophils – one form of white blood cell that causes airway inflammation in a large number of asthmatics. By inhibiting IL-5, you prevent the eosinophils from getting into the lungs to create their mischief.
One criterion for being a candidate for Nucala is having a blood eosinophil count of 300 cells/mcl.
The drug trials revealed excellent improvement in target patients who received the drug, including better control of their asthma with fewer exacerbations. Also, a large percentage of asthmatics on oral steroids were able to reduce their steroid dose or go off oral steroids while receiving Nucala.
Several patients on Nucala had shingles during the trial, so a shingles vaccine is recommended prior to starting treatment.