{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:09:02Z","timestamp":1788534542521,"version":"build-2803163510"},"reference-count":24,"publisher":"Korean Association of Internal Medicine","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021R1G1A1094123"],"award-info":[{"award-number":["2021R1G1A1094123"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS-2024-00403700"],"award-info":[{"award-number":["RS-2024-00403700"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Background\/Aims: This study investigated the clinical efficacy of low-dose mepolizumab (100 mg) in controlling severe eosinophilic asthma, aiming to induce eosinophilic granulomatosis with polyangiitis (EGPA) remission and reduce systemic steroid usage. Additionally, we constructed a basic frame for our longitudinal EGPA cohort by collecting serial blood samples before, during, and after mepolizumab treatment in EGPA patients.Methods: We conducted a 2-year prospective observational cohort study in patients with uncontrolled severe eosinophilic asthma and refractory EGPA who used systemic steroids (\u2265 7.5 mg\/day of prednisolone) or other immunosuppressant drugs for at least 6 months. All patients were treated with 100 mg of mepolizumab every 4 weeks for 1 year to control severe eosinophilic asthma and then were followed for an additional 1 year to monitor their disease course. We analyzed total systemic steroid use and EGPA remission\/relapse during the study period.Results: Three EGPA patients were included in this study and completed 16 study visits over a 2-year period. After 1 year of treatment with mepolizumab (100 mg monthly), all 3 patients were able to reduce their maintenance dose of systemic steroids, with 2 patients completely discontinuing use. These 2 patients achieved EGPA remission during mepolizumab treatment, and their remission status remained stable for 1 year after they stopped receiving the medication.Conclusions: Low-dose mepolizumab treatment demonstrated clinical efficacy in reducing the maintenance dose of systemic steroids required for severe refractory EGPA. While not all patients achieved EGPA remission with low-dose mepolizumab, some did, and their remission persisted even after treatment discontinuation.<\/jats:p>","DOI":"10.3904\/kjim.2025.130","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:32:08Z","timestamp":1767342728000},"page":"163-174","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of low-dose mepolizumab in refractory eosinophilic granulomatosis with polyangiitis: systemic steroid use and remission"],"prefix":"10.3904","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1253-6075","authenticated-orcid":true,"given":"Mi-Ae","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Kyung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Hyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jisoo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Hee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Bum","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2311155"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-00958-w"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2023.15.5.580"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2024.16.2.168"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2019.7.3.142"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1702079"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-022-02307-x"},{"key":"ref8","first-page":"295","volume-title":"Mepolizumab for eosinophilic granulomatosis with polyangiitis: a European multicenter observational study","author":"Bettiol","year":"2022"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-021-01775-z"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1341310"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/all.15934"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.03.028"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2020.12.5.885"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/art.41534"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2021.01.035"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.865318"},{"key":"ref17","volume-title":"","year":"c2024"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00485-2022"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.101279"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14147"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.01.028"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2024.107674"},{"key":"ref23","first-page":"1136","volume-title":"Oral corticosteroid stewardship: key insights from the Australasian Severe Asthma Registry","author":"Politis","year":"2024"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2022.14.3.300"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.130","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T04:45:35Z","timestamp":1768193135000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2025.130","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"assertion":[{"value":"2025-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-01","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}