Mepolizumab for Refractory Chronic Cough in Eosinophilic Airway Disease (MUCOSA) Trial

02 Apr 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

This randomized, double-blind, placebo-controlled trial evaluated whether subcutaneous mepolizumab (100 mg every 4 weeks for 12 weeks) could reduce 24-hour cough frequency in adults with refractory chronic cough and eosinophilic airways disease (sputum eosinophils ≥2%). Thirty participants were assigned 1:1 to mepolizumab or placebo.
The primary outcome was the change from baseline in 24-hour cough frequency at 14 weeks. Compared with placebo, mepolizumab did not improve the primary endpoint: the percentage change relative to placebo was +18.0% with a 95% CI of -46.4 to 160.1% (p = 0.99).
No between-group differences were observed for awake cough frequency, sleep cough frequency, cough severity on a 100-mm visual analogue scale, or quality of life on the Leicester Cough Questionnaire. Mepolizumab did reduce blood eosinophils versus placebo at week 14 (mean difference -237.7 cells/µL; 95% CI -328.3 to -147.1).
The data indicate that lowering blood and sputum eosinophils with anti-IL-5 therapy did not translate into improved cough control in this cohort, suggesting cough mechanisms may be independent of eosinophil reduction in these patients. Uncertainty remains regarding applicability beyond this single-centre study.

Clinical Editorial

European Respiratory Journal published a clinical update in Critical Care on 02 Apr 2026.

The item focuses on Mepolizumab for the treatment of refractory chronic cough in patients with eosinophilic airways disease (MUCOSA): a randomised, double-blind, parallel-group, placebo-controlled trial.

Review the original article for the full source wording and details.