May mepolizumab used in asthma correct subfertility?

Ann Med. 2021 Dec;53(1):456-458. doi: 10.1080/07853890.2021.1900591.

Abstract

İntroduction: Asthma is one of the most common chronic airway disease among reproductive period of women. Chronic inflammation in asthma, eosinophilia, high steroid treatment and uncontrolled asthma may cause infertility by affecting the reproductive organs, menstrual cycle and quality of life. Some patients with severe asthma have frequent exacerbations associated with persistent eosinophilic inflammation despite continuous treatment with high-dose inhaled glucocorticoids with or without oral glucocorticoids. Mepolizumab (anti-IL-5) is a succesful option of treatment.

Cases: First case; 25-year-old female patient has been diagnosed having asthma and rhinitis for 5 years. Even she had desired pregnancy for 3 years, she was unable to have a baby, and had been diagnosed having primary infertility. Second case; 36 years old female had rhinitis for 6 years and asthma for 4 years Although she used the same contraception method (withdrawal,condom) for years, she did not get pregnant until receiving the second dose of mepolizumab treatment.

Result: Two women were treated with mepolizumab for eosinophilic severe asthma and they got pregnant.

Conclusion: Unexplained infertility in people with severe eosinophilic asthma may be corrected by mepolizumab treatment. However, there is not enough data regarding the use of mepolizumab during pregnancy.

Keywords: Eosinophilic asthma; fertility; mepolizumab.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Asthma / complications
  • Asthma / drug therapy*
  • Dose-Response Relationship, Drug
  • Eosinophilia / drug therapy*
  • Eosinophils / drug effects
  • Eosinophils / pathology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Infertility*
  • Quality of Life
  • Rhinitis / drug therapy*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • mepolizumab