The likelihood of a reduction in the glucocorticoid-dose stratum was times greater in the mepolizumab group than in the placebo group (95% confidence interval, to ; P=). The median percentage reduction from baseline in the glucocorticoid dose was 50% in the mepolizumab group, as compared with no reduction in the placebo group (P=). Despite receiving a reduced glucocorticoid dose, patients in the mepolizumab group, as compared with those in the placebo group, had a relative reduction of 32% in the annualized rate of exacerbations ( vs. , P=) and a reduction of points with respect to asthma symptoms (P=), as measured on the Asthma Control Questionnaire 5 (in which the minimal clinically important difference is points). The safety profile of mepolizumab was similar to that of placebo.
Initial dose: 100 mg orally once a day. This dosage may be divided into two daily doses, and increased as tolerated every two to three days to a maximum recommended total daily dose of 400 mg. It is recommended that the dosage be titrated to decrease sodium retention, hypertension, weakness, hypokalemia, and any other signs or symptoms of primary hyperaldosteronism in this patient.
If this patient has an adrenal adenoma or carcinoma, the lowest possible spironolactone dosage should be given while waiting for surgery. Adrenal hyperplasia, however, usually does not respond to surgery, and chronic spironolactone therapy is recommended.
Patients with adrenal hyperplasia often require other antihypertensive therapy to control their associated hypertension.