Frontiers in Immunology | |
Effectiveness and safety of anti-IL-5/Rα biologics in eosinophilic granulomatosis with polyangiitis: a two-year multicenter observational study | |
Immunology | |
Francesco Papia1  Giuseppe Valenti1  Giuseppe Spadaro2  Nunzio Crimi3  Santi Nolasco4  Claudia Crimi4  Corrado Pelaia5  Girolamo Pelaia5  Maria Filomena Caiaffa6  Giulia Scioscia7  Massimo Triggiani8  Aikaterini Detoraki9  Alida Benfante1,10  Nicola Scichilone1,10  Alessandra Tomasello1,10  Andrea Portacci1,11  Enrico Buonamico1,11  Giovanna Elisiana Carpagnano1,11  Raffaele Campisi1,12  | |
[1] Allergology and Pulmonology Unit, Provincial Outpatient Center of Palermo, Palermo, Italy;Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy;Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy;Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy;Respiratory Medicine Unit, Policlinico “G. Rodolico-San Marco” University Hospital, Catania, Italy;Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy;Department of Medical and Surgical Sciences, School and Chair of Allergology and Clinical Immunology, University of Foggia, Foggia, Italy;Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy;Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy;Division of Internal Medicine and Clinical Immunology, Department of Internal Medicine and Clinical Complexity University of Naples Federico II, Naples, Italy;Division of Respiratory Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy;Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University “Aldo Moro”, Bari, Italy;Respiratory Medicine Unit, Policlinico “G. Rodolico-San Marco” University Hospital, Catania, Italy; | |
关键词: EGPA; eosinophilic granulomatosis with polyangiitis; Churg-Strauss; mepolizumab; benralizumab; IL-5; remission; oral corticosteroid; | |
DOI : 10.3389/fimmu.2023.1204444 | |
received in 2023-04-12, accepted in 2023-06-05, 发布年份 2023 | |
来源: Frontiers | |
【 摘 要 】
BackgroundEosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterized by asthma, systemic manifestations, and blood and tissue eosinophilia.ObjectiveTo assess the effectiveness and safety of mepolizumab (anti-IL-5) and benralizumab (anti-IL-5Rα) in EGPA for 24 months.MethodsWe conducted a multicenter observational study, including patients with EGPA treated with anti-IL-5/Rα biologics in 9 Italian specialized facilities. Systemic disease activity, remission and relapse rate were evaluated from 3 to 24 months after treatment initiation. Respiratory outcomes, hematological parameters, corticosteroid (OCS) and immunosuppressants consumption were also assessed.Results49 patients with relapsing-refractory EGPA were included [26 (53.1%) benralizumab 30mg, 20 (40.8%) mepolizumab 100mg, 3 (6.1%) mepolizumab 300mg]. Overall, 38.8% and 57.1% achieved remission after 12 and 24 months, respectively (69.2% benralizumab and 43.5% mepolizumab). Lower OCS intake and higher blood eosinophil count at baseline were associated with remission at 24 months. Both biologics exerted beneficial effects on severe asthma outcomes. Indeed, 61.2% (61.5% benralizumab and 60.8% mepolizumab) remained exacerbation-free during treatment. Lung function parameters showed improvements in the overall cohort (all p<0.05), but began to decline from month 12, especially with mepolizumab. Marked reduction in blood eosinophils was registered with mepolizumab (p<0.0001), while benralizumab depleted both eosinophils (p<0.0001) and basophils (p<0.0001). In general, 69.6% (76% benralizumab and 61.9% mepolizumab) of OCS-dependent patients lowered their daily dose by 75%, while 28.3% discontinued these drugs. Immunosuppressants were suspended in 88.2% of cases. Adverse events were reported in 8.2% of patients.ConclusionsThese real-world data suggest that anti-IL-5/Rα biologics are effective and safe in the long-term as add-on treatments for patients with EGPA.
【 授权许可】
Unknown
Copyright © 2023 Nolasco, Portacci, Campisi, Buonamico, Pelaia, Benfante, Triggiani, Spadaro, Caiaffa, Scioscia, Detoraki, Valenti, Papia, Tomasello, Crimi, Scichilone, Pelaia, Carpagnano and Crimi
【 预 览 】
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RO202310101234425ZK.pdf | 4065KB | download |