Name of the Procedure:

Injection, Mepolizumab, 1 mg (HCPCS Code: C9473)
Common Name: Mepolizumab Injection

Summary

Mepolizumab injection is a medication administered to reduce the number of eosinophils (a type of white blood cell) in the blood, thereby controlling inflammation and providing relief from symptoms of certain medical conditions.

Purpose

The primary purpose of mepolizumab injection is to treat conditions associated with high eosinophil levels, such as severe asthma and eosinophilic granulomatosis with polyangiitis (EGPA). The goal is to manage symptoms, reduce inflammation, and improve patients’ quality of life by preventing asthma flare-ups or reducing the severity of symptoms associated with EGPA.

Indications

• Severe eosinophilic asthma that is not adequately controlled with standard inhaled corticosteroids.
• Eosinophilic granulomatosis with polyangiitis (EGPA).

Patients with elevated eosinophil levels, recurrent asthma exacerbations, and symptoms not controlled by other treatments are considered appropriate candidates.

Preparation

• No specific fasting required.
• Patients should inform their healthcare provider about all medications they are currently taking.
• Relevant diagnostic tests may include blood eosinophil counts and lung function tests.

Procedure Description

1. A healthcare provider will confirm the patient’s identity and review their medical history.
2. The injection site (usually the upper arm, thigh, or abdomen) is cleaned with an antiseptic wipe.
3. Mepolizumab is administered subcutaneously using a pre-filled syringe or autoinjector.
4. The area is observed for any immediate adverse reactions.

Tools and Equipment:

• Mepolizumab pre-filled syringe or autoinjector
• Antiseptic wipes
• Sterile gauze or cotton ball

Anesthesia or Sedation:

• None required, as the procedure involves a simple subcutaneous injection.

Duration

The injection process typically takes about 10-15 minutes, including preparation and observation time.

Setting

The procedure is performed in an outpatient setting, such as a doctor’s office, clinic, or hospital outpatient department.

Personnel

• Healthcare provider (e.g., nurse, physician assistant, or doctor) trained to administer injections.

Risks and Complications

Common Risks:

• Injection site reactions (pain, redness, swelling)
• Headache
• Back pain

Rare Risks:

• Serious allergic reactions (anaphylaxis)
• Herpes zoster infection
• Lower respiratory tract infections

Management: Adverse effects will be monitored and managed promptly, with emergency procedures available for severe allergic reactions.

Benefits

• Reduction in the frequency and severity of asthma attacks or EGPA symptoms.
• Improved breathing and overall asthma control.
• Enhanced quality of life.

Patients might notice improvements within a few weeks to a couple of months after starting treatment.

Recovery

Post-Procedure Care:

• Monitor the injection site for any signs of infection or severe reaction.
• Follow any specific instructions from the healthcare provider.

Recovery Time: Patients can resume normal activities immediately after administration, barring any adverse reactions.

Alternatives

• Oral corticosteroids: Effective but associated with more side effects with long-term use.
• Biologic treatments: Other options like omalizumab or reslizumab may be considered.
• Lifestyle modifications and other inhaled medications: For milder cases or as supplementary treatments.

Pros and Cons: Mepolizumab specifically targets eosinophils with fewer systemic side effects compared to oral corticosteroids but may be more expensive and require regular injections.

Patient Experience

During the Procedure:

• Mild discomfort or pain at the injection site.
• May experience slight stinging sensation during the injection.

After the Procedure:

• Minor soreness or redness at the injection site.

• Most patients tolerate the medication well with minimal side effects.

  Pain Management:

• Over-the-counter pain relievers (e.g., acetaminophen) can be used if needed.
• Cold packs may help reduce swelling at the injection site.