Name of the Procedure:

Injection, Mepolizumab, 1 mg (J2182)

• Common Names: Mepolizumab Injection, Nucala
• Technical/Medical Term: Mepolizumab Subcutaneous Injection

Summary

Mepolizumab injection involves administering a medication called mepolizumab to help control specific types of inflammatory and allergic conditions. It's usually given as a subcutaneous (under-the-skin) injection.

Purpose

• Medical Conditions Addressed: Severe eosinophilic asthma, Eosinophilic granulomatosis with polyangiitis (EGPA), Hypereosinophilic syndrome (HES).
• Goals/Outcomes: The primary goal is to reduce the number of eosinophils (a type of white blood cell) in the blood, alleviating symptoms such as frequent asthma exacerbations, breathing difficulties, and other related complications. Expected outcomes include improved breathing, reduced frequency of asthma attacks, and overall better quality of life.

Indications

• Symptoms: Severe asthma not controlled with standard treatments, frequent asthma attacks requiring corticosteroids, chronic respiratory issues, and specific bloodwork showing high eosinophil levels.
• Criteria: Patients with a confirmed diagnosis of severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis, or hypereosinophilic syndrome.

Preparation

• Pre-Procedure Instructions: Generally, no major preparation is needed. However, patients should inform their healthcare provider about all current medications and any known allergies.
• Diagnostics Tests/Assessments: Baseline blood tests to determine eosinophil levels; pulmonary function tests may be performed to gauge respiratory status.

Procedure Description

1. The patient arrives at the healthcare setting.
2. The healthcare provider prepares a syringe with the prescribed dose of mepolizumab (1 mg is the billing unit; the actual dose may vary).
3. The injection site is cleaned, typically the upper arm, thigh, or abdomen.
4. The medication is injected subcutaneously (under the skin).
5. The patient is observed for a short period post-injection to monitor for any adverse reactions.

• Tools/Equipment: Syringe and needle, antiseptic swab, mepolizumab solution.
• Anesthesia/Sedation: Not typically required for this procedure.

Duration

• The procedure itself generally takes about 10-15 minutes, including preparation and post-injection observation.

Setting

• This procedure is typically performed in an outpatient clinic, physician's office, or a specialized treatment center.

Personnel

• Typically administered by a trained nurse or a healthcare provider with experience in giving subcutaneous injections.

Risks and Complications

• Common Risks: Local reactions at the injection site (redness, swelling, pain), mild headache, fatigue.
• Rare Risks: Hypersensitivity reactions (rash, hives, anaphylaxis), which require immediate medical attention.

Benefits

• Expected benefits include reduced frequency and severity of asthma attacks, improved lung function, and decreased need for oral corticosteroids.
• Benefits can often be observed within weeks to a few months of regular treatment.

Recovery

• Post-Procedure Care: The patient can resume normal activities immediately but should monitor the injection site for any signs of infection or adverse reactions.
• Expected Recovery Time: No significant recovery time is needed; routine monitoring and follow-up appointments are typically scheduled to assess effectiveness and manage any ongoing symptoms.

Alternatives

• Other Treatment Options: Other biologic drugs (e.g., omalizumab), inhaled corticosteroids and long-acting beta-agonists, lifestyle changes, and regular asthma management plans.
• Pros and Cons of Alternatives: Alternatives might have different efficacy profiles, side effects, and costs. Mepolizumab is specifically targeted at eosinophilic inflammation, which may not be the primary mechanism in all asthma patients.

Patient Experience

• During the Procedure: Patients might feel a slight prick or sting at the injection site, followed by mild pressure.
• After the Procedure: Common experiences include minor discomfort or swelling at the injection site, which typically resolves on its own. Pain management is usually not necessary but can include cold compresses or over-the-counter pain relief if needed.

For those receiving mepolizumab injections, the overall experience tends to be straightforward, with most patients noting improvements in their symptoms and quality of life over time.