Expert Consensus on the Clinical Application of Anti-Interleukin-5 Monoclonal Antibodies_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 CHANG Chun ¹ , CHEN Yahong ¹ , CHEN Yan ² , DENG Jingmin ³ , DING Shigang ⁴ , DONG Hangming ⁵ , HE Zhiyi ³ , JING Hongmei ⁶ , LI Wen ⁷ , MU Rong ⁸ , TANG Hao ⁹ , WANG Gang ¹⁰ , XIE Lifeng ¹¹ , XIE Min ¹² , YAN Yan ¹¹ , YIN Yan ¹³ , YING Songmin ¹⁴ ,  SUN Yongchang ¹

1. Department of Respiratory and Critical Care Medicine, Peking University Third Hospital (Beijing 100191);
2. Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital of Central South University (Changsha, Hunan 410011);
3. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University (Nanning, Guangxi 530021);
4. Department of Gastroenterology, Peking University Third Hospital (Beijing 100191);
5. Department of Respiratory and Critical Care Medicine, Nanfang Hospital (Guangzhou, Guangdong 510515);
6. Department of Hematology, Peking University Third Hospital (Beijing 100191);
7. Department of Respiratory Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine (Hangzhou, Zhejiang 310009);
8. Department of Rheumatology and Immunology, Peking University Third Hospital (Beijing 100191);
9. Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Naval Medical University (Shanghai 200003);
10. Department of Respiratory and Critical Care Medicine, West China Hospital Sichuan University (Chengdu, Sichuan 610041)/ Center of Excellence in Severe Asthma and Treatable Traits, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital Sichuan University (Chengdu, Sichuan 610041);
11. Department of Otorhinolaryngology, Peking University Third Hospital (Beijing 100191);
12. Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (Wuhan, Hubei 430030);
13. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University (Shenyang, Liaoning 110001);
14. School of Medicine, Zhejiang University (Hangzhou, Zhejiang 310058);

Corresponding?author：

CHANG Chun, Email: suny@bjmu.edu.cn; SUN Yongchang, Email: changc@bjmu.edu.cn

Keywords：

Anti-interleukin 5 monoclonal antibodies; asthma; chronic rhinosinusitis with nasal polyps; eosinophilic granulomatosis with polyangiitis; hypereosinophilic syndrome; chronic obstructive pulmonary disease; allergic bronchopulmonary aspergillosis; eosinophil-related diseases

DOI：

10.7507/1671-6205.202604012

Video：

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Abstract Full text Figures/Tables Video References Cited by

Since the launch of anti-interleukin 5 monoclonal antibodies (anti-IL-5 mAbs), they have been widely used in various disease fields. The classic indications include severe eosinophilic asthma (SEA), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic granulomatosis with polyangiitis (EGPA), hypereosinophilic syndrome (HES), and chronic obstructive pulmonary disease (COPD). Moreover, there is evidence suggesting that anti-IL-5 mAbs can also be used in the treatment of allergic bronchopulmonary aspergillosis (ABPA) and other uncommon eosinophil (EOS)-related diseases. To standardize the clinical application of anti-IL-5 mAbs by clinicians, the expert group formulated a consensus by extensive review of high-quality clinical research data and authoritative guideline documents. The consensus paper was written based on the current best clinical evidence and Chinese clinical practice experience, aiming to provide authoritative reference and practical guidance for clinical colleagues in the standardized clinical use of anti-IL-5 mAbs. The content of this consensus covers the mechanism of anti-IL-5 mAbs, dosing regimens for different diseases, management strategies, etc. It emphasizes the importance of individualized diagnosis and treatment guided by biomarkers, long-term standardized follow-up, and multidisciplinary team collaboration.

Citation： CHANG Chun, CHEN Yahong, CHEN Yan, DENG Jingmin, DING Shigang, DONG Hangming, HE Zhiyi, JING Hongmei, LI Wen, MU Rong, TANG Hao, WANG Gang, XIE Lifeng, XIE Min, YAN Yan, YIN Yan, YING Songmin, SUN Yongchang. Expert Consensus on the Clinical Application of Anti-Interleukin-5 Monoclonal Antibodies. Chinese Journal of Respiratory and Critical Care Medicine, 2026, 25(4): 229-239. doi: 10.7507/1671-6205.202604012 Copy

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1. Travers J, Rothenberg ME. Eosinophils in mucosal immune responses. Mucosal Immunol, 2015, 8(3): 464-475.
2. Fulkerson PC, Rothenberg ME. Targeting eosinophils in allergy, inflammation and beyond. Nat Rev Drug Discov, 2013, 12(2): 117-129.
3. Xu J, Zeng Q, Li S, et al. Inflammation mechanism and research progress of COPD. Front Immunol, 2024, 15: 1404615.
4. 曹雪濤, 主編. 醫學免疫學. 第8版. 北京: 人民衛生出版社, 2024: 23.
5. Yang M, Lv Y, Tang S, et al. Blood Eosinophil Count and Its Determinants in a Chinese Population-Based Cohort. Respiration, 2024, 103(2): 70-78.
6. Rimkunas A, Januskevicius A, Vasyle E, et al. The Effect of Mepolizumab on Blood Eosinophil Subtype Distribution and Granule Protein Gene Expression in Severe Eosinophilic Asthma. J Asthma Allergy, 2025, 18: 455-466.
7. West N, Williams S, Sinclair J, et al. CosMx? single cell spatial imaging identifies changes in spatial cell communication in chronic rhinosinusitis with nasal polyps following anti-IL-5 treatment[C]. EAACI Congress 2024. Poster 001871.
8. Matucci A, Accinno M, Maggiore G, et al. Mepolizumab Reduces Inflammatory Eosinophils in Nasal Polyp Tissue and Restores Histological Alterations. J Investig Allergol Clin Immunol, 2025 Jul 4. [Epub ahead of print].
9. Tanaka H, Komai M, Nagao K, et al. Role of interleukin-5 and eosinophils in allergen-induced airway remodeling in mice. Am J Respir Cell Mol Biol, 2004, 31(1): 62-68.
10. Drummond I, Phillips J, Dhillon R, et al. Mepolizumab reduces markers of airway remodelling in bronchial biopsies from patients with severe eosinophilic asthma after 6 months of treatment[C]. ERS 2025. Poster PA4609.
11. Zhu Z, Chen X, Luo Y, et al. An evaluation of mepolizumab as an add-on maintenance treatment for severe eosinophilic asthma. Expert Opin Biol Ther, 2025, 25(3): 209-220.
12. Domvri K, Tsiouprou I, Bakakos P, et al. Effect of mepolizumab in airway remodeling in patients with late-onset severe asthma with an eosinophilic phenotype. J Allergy Clin Immunol, 2025, 155(2): 425-435.
13. Domvri K, Tsiouprou I, Bakakos P, et al. Effect of Mepolizumab on airways remodeling in patients with late-onset severe eosinophilic asthma and fixed obstruction (preliminary data of the MESILICO study). Eur Respir J, 2023, 62(suppl 67): OA3152.
14. Kobayashi K, Nagase H, Sugimoto N, et al. Mepolizumab decreased the levels of serum galectin-10 and eosinophil cationic protein in asthma. Asia Pac Allergy, 2021, 11(3): e31.
15. Hamakawa M, Ishida T. Usefulness of Mepolizumab for Mucus Plugs. Intern Med, 2024, 63(6): 851-852.
16. Bergantini L, Pianigiani T, d‘Alessandro M, et al. The effect of anti-IL5 monoclonal antibodies on regulatory and effector T cells in severe eosinophilic asthma. Biomed Pharmacother, 2023, 166: 115385.
17. GlaxoSmithKline UK Ltd. Nucala 100 mg solution for injection (EMA Summary of Product)[Z]. London: 2025 Dec.
18. GlaxoSmithKline LLC. NUCALA (mepolizumab) injection, for subcutaneous use (U. S. Prescribing Information)[Z]. Philadelphia: 2025 May.
19. 葛蘭素史克企業管理有限公司. 美泊利珠單抗注射液說明書[Z]. 上海: 2025年12月.
20. Stanziola AA, Candia C, Nazzaro G, et al. Long-term effects of mepolizumab in patients with severe eosinophilic asthma: a 6-year real-life experience. Front Pharmacol, 2024, 15: 1449220.
21. Chen R, Wei L, Dai Y, et al. Efficacy and safety of mepolizumab in a Chinese population with severe asthma: a phase Ⅲ, randomised, double-blind, placebo-controlled trial. ERJ Open Res, 2024, 10(3): 00750-2023.
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