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ANCA-associated vasculitis — SCE Rheumatology MCQ

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HardMusculoskeletal investigationsANCA-associated vasculitisSCE Rheumatology

A patient with relapsing non-organ-threatening EGPA is starting mepolizumab. Which baseline counselling point correctly distinguishes its use from induction of life-threatening vasculitis?

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Correct answer: A — Administer mepolizumab 300 mg subcutaneously every 4 weeks for relapsing EGPA

A is correct. Adult EGPA dosing is 300 mg subcutaneously every 4 weeks, with continued review of disease control and background therapy. The SmPC notes that life-threatening EGPA was not studied, so new myocarditis, renal disease or alveolar haemorrhage requires urgent reclassification and organ-threatening induction. Immediate steroid cessation and eosinophil-zero dosing are unsafe targets.

Reference: Mepolizumab UK SmPC. https://www.medicines.org.uk/emc/product/1938/smpc