Egpa

A full map of EGPA therapy — why reduced-dose steroid regimens validated in GPA and MPA may not transfer, what REOVAS and MAINRITSEG actually showed about rituximab (no superiority in either), and how anti-IL-5 therapy has made complete glucocorticoid withdrawal a realistic trial endpoint. Also carries a development many will have missed: avacopan’s marketing approval is being withdrawn after ADVOCATE’s primary endpoint data were found to have been manipulated.

A 2026 narrative review of the IL-5/eosinophil axis in eosinophilic granulomatosis with polyangiitis (EGPA) and the two approved IL-5 pathway inhibitors — mepolizumab and benralizumab — covering their mechanisms, MIRRA and MANDARA trial evidence, real-world data, guideline positioning, and the remaining unmet needs.