Mepolizumab-induced Changes in Nasal Methylome and Transcriptome to Predict Response in Asthma

We aimed to detect a predictive or early nasal gene expression and/or DNA methylation signature that could identify responders or non-responders to Mepolizumab at one year. Overall design: Data for 27 asthma patients enrolled in The PROCLAIM study (Poor Response tO monoClonaL therApy In asthMa) who matched the UK NHS criteria for receiving Mepolizumab was used (ethics REC18/EM/0268). Nasal brushes were taken at baseline (pre-drug) and after 3-months of treatment. Responders were defined as patients who had a 50% reduction in oral corticoid steroid use and/or 50% reduction in exacerbation frequency after one year (NICE guidelines, TA431, 2017). Gene expression was compared between responders and non-responders at baseline and at 3 months post mepolizumab treatment.