{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:49:20Z","timestamp":1791679760166,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","award":["GSK ID: MEA116841"],"award-info":[{"award-number":["GSK ID: MEA116841"]}],"id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, relapsing, inflammatory disease. Management of EGPA predominantly relies on oral corticosteroids (OCS), which are associated with many adverse effects. The phase 3 MIRRA trial demonstrated efficacy and safety of mepolizumab, anti\u2010interleukin\u20105 biologic, for EGPA. This open\u2010label extension (OLE) of MIRRA assessed long\u2010term safety and OCS\u2010sparing effects of mepolizumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The OLE (NCT03298061) was a multicenter study that enrolled patients from MIRRA who required OCS \u22655 mg\/day up to six months after the end of MIRRA. All patients received mepolizumab 300 mg subcutaneously every four weeks plus standard of care until mepolizumab was discontinued or became approved and reimbursed for EGPA in the respective country. Key outcomes included adverse events (AEs) and use of OCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred patients were enrolled in the OLE. Mean (SD) and median (min\u2013max) exposure during OLE was 38.5 (27.0) and 27.0 (1.0\u201389.0) months. On\u2010treatment AEs were experienced by 98% of patients (43% treatment related; most frequent: injection site reaction [10%]) and serious AEs by 38% of patients (6% treatment related) with no new safety signals versus MIRRA identified. Median (Q1\u2013Q3) OCS dose decreased from 10.0 (7.8\u201315.0) mg\/day at OLE baseline to 5.0 (0.0\u201310.0) mg\/day at study exit. Proportion of patients using OCS &gt;7.5 mg\/day decreased from 75% at baseline to 32% at study exit; 28% of patients discontinued OCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long\u2010term use of mepolizumab to treat EGPA was well tolerated and resulted in sustained reductions in OCS use.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art43146-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.43146","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T01:58:30Z","timestamp":1741744710000},"page":"1052-1062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Long\u2010Term Safety and Efficacy of Mepolizumab in Eosinophilic Granulomatosis With Polyangiitis"],"prefix":"10.1002","volume":"77","author":[{"given":"Michael E.","family":"Wechsler","sequence":"first","affiliation":[{"name":"National Jewish Health  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Silver","sequence":"additional","affiliation":[{"name":"GSK  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Wolff","sequence":"additional","affiliation":[{"name":"GSK  Collegeville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Price","sequence":"additional","affiliation":[{"name":"GSK  Stevenage Hertfordshire United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rejina","family":"Verghis","sequence":"additional","affiliation":[{"name":"GSK  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Weller","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Merkel","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1800-0079","authenticated-orcid":false,"given":"Paneez","family":"Khoury","sequence":"additional","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland. Members of the EGPA Mepolizumab Open\u2010Label Extension study group are listed in Appendix A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EGPA Mepolizumab Open\u2010Label Extension Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-00958-w"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.12.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37721"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00097-2016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22686"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221794"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11263"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez570"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41773"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223764"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2016.22.7.833"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2016.1233101"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S176026"},{"key":"e_1_2_8_15_1","author":"European Medicines Agency (EMA)","journal-title":"Mepolizumab (Nucala) summary of product characteristics"},{"key":"e_1_2_8_16_1","article-title":"Prescribing information","author":"Mepolizumab (Nucala)","year":"2023","journal-title":"GlaxoSmithKline"},{"key":"e_1_2_8_17_1","article-title":"Prescribing information (Japan)","author":"Mepolizumab (Nucala)","year":"2023","journal-title":"GlaxoSmithKline"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1702079"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00509-2023"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2311155"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.11.041"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11571"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41943"},{"key":"e_1_2_8_24_1","first-page":"roae100","article-title":"Real\u2010world safety and effectiveness of mepolizumab for patients with eosinophilic granulomatosis with polyangiitis in Japan: long\u2010term observation of the MARS study","author":"Ishii T","year":"2024","journal-title":"Mod Rheumatol"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330806"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-023-00801-7"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.37349\/eaa.2024.00058"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1457202"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.08.037"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.07.050"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11092424"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.09.033"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2019.07.007"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2016.07.010"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00396-2021"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2417184"},{"issue":"461","key":"e_1_2_8_37_1","article-title":"Long\u2010term safety of mepolizumab for the treatment of hypereosinophilic syndromes","volume":"131","author":"Roufosse FE","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.05.009"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1310211"}],"container-title":["Arthritis &amp; 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