Ms. Brechtelsbauer’s vasculitis began in 2009 with diffuse urticaria, but it took doctors several years to diagnose it, even though a skin biopsy revealed high eosinophil counts. She developed asthma, and then eosinophilic pneumonia. She tested negative for anti-neutrophil cytoplasmic antibodies (ANCA) but has since learned that only half of all patients have them.
At one point, she said, “I was on 10 different medications just to breathe,” she said. She was getting high-dose prednisone and finally began to improve a bit when doctors put her on omalizumab (Xolair). Even so, she endured five surgeries over five years. In the midst of one of them, she developed a new allergy to the anesthesia that nearly killed her. When she went into cardiac arrest, doctors had to perform CPR for two minutes to resuscitate her.
At a June 2015 vasculitis conference in Jacksonville, Fla., she had heard about promising new results from mepolizumab. When the FDA approved the drug in November 2015 to treat adults with eosinophilic asthma, “I was in my doctor’s office the next week, saying, ‘I want this,’” she recalled. “I knew about the Nucala approval before my immunologist.”