Respiratory medicine: anti-IL-5 therapy in eosinophilic asthma: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: anti-IL-5 therapy in eosinophilic asthma

Sample item

A 45-year-old with late-onset severe asthma and nasal polyps has blood eosinophils of 700 per microlitre and normal total IgE. He has exacerbations despite high-dose inhaled steroid plus long-acting beta-agonist. Which biological agent is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Mepolizumab

Mepolizumab is an antibody against interleukin-5, the key cytokine for eosinophil maturation and survival, and reduces exacerbations in severe eosinophilic asthma. Omalizumab needs raised IgE with allergic sensitisation, which this patient lacks.

Option by option

  • A. Omalizumab

    Omalizumab targets IgE, which is normal in this patient.

  • B. Rituximab

    Rituximab depletes B cells and has no role in asthma.

  • C. Tocilizumab

    Tocilizumab blocks the interleukin-6 receptor and is used in rheumatoid arthritis.

  • D. Mepolizumab (correct)

    Correct. Anti-interleukin-5 therapy targets the eosinophilic phenotype.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Mepolizumab. Mepolizumab is an antibody against interleukin-5, the key cytokine for eosinophil maturation and survival, and reduces exacerbations in severe eosinophilic asthma.

Why is "Omalizumab" not the answer?

Omalizumab targets IgE, which is normal in this patient.

Why is "Rituximab" not the answer?

Rituximab depletes B cells and has no role in asthma.

Why is "Tocilizumab" not the answer?

Tocilizumab blocks the interleukin-6 receptor and is used in rheumatoid arthritis.

What concept does this question test?

It tests Respiratory medicine: anti-IL-5 therapy in eosinophilic asthma in General Medicine. Omalizumab needs raised IgE with allergic sensitisation, which this patient lacks.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: anti-IL-5 therapy in eosinophilic asthma?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.