Corrado Pelaia1, Claudia Crimi2, Girolamo Pelaia1, Santi Nolasco2, Raffaele Campisi2, Enrico Heffler3, Giuseppe Valenti4, Nunzio Crimi2. 1. Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy. 2. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. 3. Personalized Medicine Asthma and Allergy Clinic, Humanitas University, Rozzano, Italy. 4. Allergology and Pulmonology Unit, Provincial Outpatient Center of Palermo, Palermo, Italy.
Abstract
BACKGROUND: Anti-interleukin-5 (IL-5) monoclonal antibodies can be used as add-on biological therapies in allergic and non-allergic patients with severe eosinophilic asthma. However, within such a therapeutic context real-life investigations are lacking. OBJECTIVE: Therefore, the aim of the present observational study was to evaluate the effects of mepolizumab in allergic and non-allergic subjects with severe eosinophilic asthma. METHODS: Relevant clinical, functional, laboratory, and pharmacotherapeutic parameters were assessed in the above patient subgroups. RESULTS: After one year of add-on biological treatment with mepolizumab, our 88 patients experienced a remarkable improvement of their severe asthma, documented by a better symptom control, expressed by a significant improvement in asthma control test (ACT) score. Indeed, the mean value (±standard deviation) of ACT score increased from 12.55 (±3.724) to 21.08 (±3.358). Moreover, significant improvements were also detected with regard to the median values (interquartile range) of forced expiratory volume in one second (FEV1 ), blood eosinophil numbers, annual rate of disease exacerbations, and daily intake of oral corticosteroids (OCS). In particular, FEV1 enhanced from 1640 mL (1110-2275) to 1920 mL (1525-2615), blood eosinophil count dropped from 711.0 cells/μL (500.0-1022) to 90.00 cells/μL (50.00-117.5), the annual rate of asthma exacerbations decreased from 3.000 (2.000-6.000) to 0.000 (0.000-1.000), and the daily prednisone intake fell from 6.250 mg (0.000-25.00) to 0.000 mg (0.000-0.000). After one year of mepolizumab treatment, the improvements in clinical, functional, and haematological parameters were quite similar in patient subgroups characterized by skin prick test (SPT) negativity or positivity, respectively. A significant correlation was observed between serum IgE levels and OCS intake decrease (r = -0.2257; P < .05). CONCLUSION AND CLINICAL RELEVANCE: Hence, our real-life data suggest that mepolizumab can represent a valid add-on therapeutic option for patients with severe eosinophilic asthma, irrespective of IgE serum concentrations, and allergic sensitization.
BACKGROUND:Anti-interleukin-5 (IL-5) monoclonal antibodies can be used as add-on biological therapies in allergic and non-allergicpatients with severe eosinophilic asthma. However, within such a therapeutic context real-life investigations are lacking. OBJECTIVE: Therefore, the aim of the present observational study was to evaluate the effects of mepolizumab in allergic and non-allergic subjects with severe eosinophilic asthma. METHODS: Relevant clinical, functional, laboratory, and pharmacotherapeutic parameters were assessed in the above patient subgroups. RESULTS: After one year of add-on biological treatment with mepolizumab, our 88 patients experienced a remarkable improvement of their severe asthma, documented by a better symptom control, expressed by a significant improvement in asthma control test (ACT) score. Indeed, the mean value (±standard deviation) of ACT score increased from 12.55 (±3.724) to 21.08 (±3.358). Moreover, significant improvements were also detected with regard to the median values (interquartile range) of forced expiratory volume in one second (FEV1 ), blood eosinophil numbers, annual rate of disease exacerbations, and daily intake of oral corticosteroids (OCS). In particular, FEV1 enhanced from 1640 mL (1110-2275) to 1920 mL (1525-2615), blood eosinophil count dropped from 711.0 cells/μL (500.0-1022) to 90.00 cells/μL (50.00-117.5), the annual rate of asthma exacerbations decreased from 3.000 (2.000-6.000) to 0.000 (0.000-1.000), and the daily prednisone intake fell from 6.250 mg (0.000-25.00) to 0.000 mg (0.000-0.000). After one year of mepolizumab treatment, the improvements in clinical, functional, and haematological parameters were quite similar in patient subgroups characterized by skin prick test (SPT) negativity or positivity, respectively. A significant correlation was observed between serum IgE levels and OCS intake decrease (r = -0.2257; P < .05). CONCLUSION AND CLINICAL RELEVANCE: Hence, our real-life data suggest that mepolizumab can represent a valid add-on therapeutic option for patients with severe eosinophilic asthma, irrespective of IgE serum concentrations, and allergic sensitization.
Authors: Catherine Lemiere; Camille Taillé; Jason Kihyuk Lee; Steven G Smith; Stephen Mallett; Frank C Albers; Eric S Bradford; Steven W Yancey; Mark C Liu Journal: Respir Res Date: 2021-06-22
Authors: Charlene M Prazma; Marco Idzko; Jo Anne Douglass; Arnaud Bourdin; Stephen Mallett; Frank C Albers; Steven W Yancey Journal: J Asthma Allergy Date: 2021-06-14