BACKGROUND: Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti-IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. OBJECTIVE: The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. METHODS: This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. RESULTS: Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. CONCLUSION: Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability. Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
BACKGROUND: Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti-IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. OBJECTIVE: The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. METHODS: This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. RESULTS:Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. CONCLUSION:Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability. Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Authors: Alana B Levine; George Kalliolias; Mark Heaney; Yoshimi Endo; Adam Gersten; Jonathan W Weinsaft; Robert F Spiera; Anne Bass; Doruk Erkan Journal: HSS J Date: 2012-06-23
Authors: Jonathan Steinfeld; Eric S Bradford; Judith Brown; Stephen Mallett; Steven W Yancey; Praveen Akuthota; Maria C Cid; Gerald J Gleich; David Jayne; Paneez Khoury; Carol A Langford; Peter A Merkel; Frank Moosig; Ulrich Specks; Peter F Weller; Michael E Wechsler Journal: J Allergy Clin Immunol Date: 2018-12-19 Impact factor: 10.793
Authors: Michael E Wechsler; Praveen Akuthota; David Jayne; Paneez Khoury; Amy Klion; Carol A Langford; Peter A Merkel; Frank Moosig; Ulrich Specks; Maria C Cid; Raashid Luqmani; Judith Brown; Stephen Mallett; Richard Philipson; Steve W Yancey; Jonathan Steinfeld; Peter F Weller; Gerald J Gleich Journal: N Engl J Med Date: 2017-05-18 Impact factor: 91.245