**5. Conclusions**

The pathogenesis and role of ANCA in EGPA are mostly unknown, although it has been reported that patients with positive ANCA usually present renal involvement (glomerulonephritis), while those with negative ANCA usually have cardiac involvement (heart failure), possibly corresponding to two different subgroups with different characteristics still to be determined which will provide information and facilitate specific treatments. GC and IS are effective in EGPA, but relapses are frequent, and there is no standard therapy based on the results of randomized clinical trials. However, there is new data that shows mepolizumab as a good treatment option due to its clinical benefit, and its use in EGPA has recently been approved in the United States.

Advances in the knowledge of EGPA pathophysiology together with the appearance of new drugs, such as mepolizumab, seems to be a solution to the unmet needs in this disease.
