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NICE backs first-in-class biologic treatment for asthma

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Asthma experts have welcomed the decision to provisionally approve a new drug for use in the NHS in England, which could help transform the lives of those with severe symptoms.

Mepolizumab (Nucala) is one of the first in a new line of “monoclonal antibody treatments” designed to combat a particularly debilitating form of asthma called severe eosinophilic asthma.

“It has the potential to transform the lives of many people”

Kay Boycott

The drug works by targeting the specific white blood cells – eosinophils – responsible for symptoms such as constant breathlessness.

Despite already being available in Scotland, the drug was previously rejected for use in England by the National Institute for Health and Care Excellence due to concerns about its cost effectiveness.

However, NICE has reviewed its initial draft decision in light of new evidence from the drug’s maker GlaxoSmithKline and a drop in price, alongside lobbying by organisations like the charity Asthma UK.

As a result, it is now recommended by NICE as a treatment option in certain circumstances in the latest version of draft guidance on care for adults with severe asthma, currently out for consultation.

Previously many people with severe asthma were reliant on steroid medication, which can cause serious side effects like hypertension, diabetes and mood swings if used over a long period of time.

Asthma UK

Kay Boycott

Kay Boycott

Asthma UK hailed the decision to recommend mepolizumab, which is given by injection every four weeks, as a breakthrough and urged NHS leaders to ensure it was widely available. The charity estimated that around 100,000 patients in England and Wales had severe eosinophilic asthma.

“We are delighted that mepolizumab has finally been recommended for use on the NHS,” said chief executive Kay Boycott. “It has the potential to transform the lives of many people with one of the most debilitating forms of asthma,” she said.

“Not only should it improve some people’s symptoms and reduce the risk of life-threatening asthma attacks, but we also hope it will reduce their reliance on high doses of corticosteroids which can have unpleasant and harmful side effects in the long term,” said Ms Boycott.

She added: “We now need to see mepolizumab made available to those who need it as soon as possible.”

The latest version of the NICE guidance on the drug will now be consulted on before binding recommendations are published that trusts must comply with.

The drug’s list cost is £840 per dose but the price the NHS would actually pay is confidential, noted NICE.

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