Nucala mepolizumab

The steroid-exit story is Nucala's most powerful adherence driver and its biggest retention risk: patients who expect dramatic early relief drop off before the 3-month inflection point where real benefit crystallizes.

• Steroid freedom is the dominant emotional win reported by long-term Nucala users across asthma and CRSwNP, often described in near-miraculous terms after years of prednisone dependence.
• Onset lag of 8 to 16 weeks is the single highest abandonment risk moment: patients expecting quick relief disengage before the clinically meaningful improvement window opens.
• A cluster of under-labeled side effects (hair loss, joint pain, persistent fatigue, weight shift post-steroid taper) drives frustrated forum posts and repeat physician visits, yet rarely causes outright discontinuation.
• Insurance prior authorization and formulary barriers generate sustained anxiety, particularly for COPD and new indications, and are a distinct unmet need separate from clinical tolerability.