Mepolizumab and pregnancy: A case of severe eosinophilic asthma in a patient who conceived during mepolizumab treatment

A 30-year-old female patient with steroid-dependent severe eosinophilic asthma and chronic eosinophilic pneumonia had been successfully treated with mepolizumab for 15 months. At the 16th month of mepolizumab treatment, she reported an unplanned pregnancy at four weeks gestation. Biological treatment was discontinued, and the patient was managed with a combination of inhaled corticosteroids (ICS), long-acting beta-agonists (LABA), and oral steroids. Despite experiencing frequent exacerbations during follow-up, appropriate treatments were administered. The patient delivered a healthy baby via normal spontaneous vaginal delivery at 39 weeks. In the management of pregnant women with asthma, the risk-benefit ratio of the medications used should be carefully evaluated, considering the potential risk of exacerbation or uncontrolled disease if the treatment is discontinued. In the presented case, after discontinuing mepolizumab treatment, the patient experienced three exacerbations despite regular use of systemic steroids. Keywords: