Mepolizumab for maintenance treatment of uncontrolled chronic obstructive pulmonary disease with raised blood eosinophils

Mepolizumab (Nucala) is available on the NHS as a possible treatment for uncontrolled chronic obstructive pulmonary disease (COPD) in adults if they:

• have a high level of eosinophils (a type of white blood cell) in their blood
• are having triple therapy including an inhaled corticosteroid, a long-acting beta-2-agonist and a long-acting muscarinic antagonist.

You will need a blood test to measure your eosinophil levels.

Uncontrolled COPD means you have had 1 or more severe exacerbations or 2 or more moderate exacerbations in the last 12 months.

Moderate exacerbations are when a person has a flare-up of their COPD symptoms that is bad enough to need treatment with steroid tablets, antibiotics, or both. Severe exacerbations are when a flare-up of COPD symptoms is so serious it means the person needs to go to hospital.

If your condition does not improve, your healthcare professional will stop your mepolizumab after 12 months.

If you are not eligible for mepolizumab but are already having it, you should be able to continue until you and your healthcare professional decide when best to stop.

Is this treatment right for me?

Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. Your family can be involved too, if you wish. See our webpage on shared decision making.

Questions to think about

• How well does it work compared with other treatments?
• What are the risks or side effects? How likely are they?
• How will the treatment affect my day-to-day life?
• What happens if the treatment does not work?
• What happens if I do not want to have treatment? Are there other treatments available?

Information and support

The NHS webpage on COPD may be a good place to find out more.

Asthma & Lung UK (0300 222 5800) can give you advice and support.

You can also get support from your local Healthwatch.

NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.

ISBN: 978-1-4731-9563-9