Alice Canzian1, Nils Venhoff2, Maria Letizia Urban3, Silvia Sartorelli4, Anne-Marie Ruppert5, Matthieu Groh6, Nicolas Girszyn7, Camille Taillé8, François Maurier9, Vincent Cottin10, Claire de Moreuil11, Vincent Germain12, Maxime Samson13, Marie Jachiet14, Laure Denis15, Virginie Rieu15, Perrine Smets16, Grégory Pugnet17, Alban Deroux18, Cécile-Audrey Durel19, Achille Aouba20, Pascal Cathébras21, Christophe Deligny22, Stanislas Faguer23, Helder Gil24, Bertrand Godeau25, François Lifermann26, Sophie Phin-Huynh27, Marc Ruivard16, Philippe Bonniaud28, Xavier Puéchal1, Jean-Emmanuel Kahn29, Jens Thiel2, Lorenzo Dagna4, Loïc Guillevin1, Augusto Vaglio30, Giacomo Emmi3, Benjamin Terrier1. 1. National Referral Center for Rare Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris, France. 2. University Medical Center Freiburg and University of Freiburg, Freiburg, Germany. 3. University of Florence, Florence, Italy. 4. IRCCS San Raffaele, Vita-Salute San Raffaele University, Milan, Italy. 5. Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France. 6. National Referral Center for Hypereosinophilic Syndrome (CEREO), Hôpital Foch, Suresnes, France. 7. Centre Hospitalo-Universitaire, Rouen, France. 8. Hôpital Bichat, AP-HP, Nord-Université de Paris, Centre de Référence des Maladies Pulmonaires Rares, INSERM UMR 1152, Paris, France. 9. Hôpitaux Privés de Metz, Metz, France. 10. Hôpital Edouard Herriot, Lyon, France. 11. Centre Hospitalier Regional Universitaire Brest, Brest, France. 12. Centre Hospitalier de Pau, Pau, France. 13. Centre Hospitalier Universitaire (CHU) de Dijon Bourgogne, Dijon, France. 14. Hôpital Saint-Louis, Paris, France. 15. CHU de Estaing, Clermont-Ferrand, France. 16. CHU de Gabriel-Montpied, Clermont-Ferrand, France. 17. Hôpital Purpan, Toulouse, France. 18. CHU de Grenoble Alpes, Hôpital Michallon, Grenoble, France. 19. Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. 20. CHU de Caen Normandie, Caen, France. 21. CHU de Saint-Étienne, Saint-Étienne, France. 22. CHU de Martinique, Fort-de-France, France. 23. CHU de Toulouse, Hôpital Rangueil, Toulouse, France. 24. Centre Hospitalier Régional Universitaire de Besançon, Besançon, France. 25. Hôpital Henri Mondor, Créteil, France. 26. Centre Hospitalier de Dax-Côte d'Argent, Dax, France. 27. Hôpital Saint-Camille, Bry-sur-Marne, France. 28. Centre de Référence des Maladies Pulmonaires Rares, CHU de Dijon Bourgogne, Université de Bourgogne, INSERM 1231, Dijon, France. 29. Hôpital Ambroise Paré, Boulogne-Billancourt, France. 30. Azienda Ospedaliero Universitaria Meyer and University of Florence, Florence, Italy.
Abstract
OBJECTIVE: To describe the efficacy and safety of biologics for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: A retrospective European collaborative study was conducted in patients with EGPA who received treatment with biologics for refractory and/or relapsing disease. RESULTS: Among the 147 patients with EGPA included in the study, 63 received rituximab (RTX), 51 received mepolizumab (MEPO), and 33 received omalizumab (OMA). At the time of inclusion, the median Birmingham Vasculitis Activity Score (BVAS) was 8.5 (interquartile range [IQR] 5-13) in the RTX group, while the median BVAS in the OMA group was 2 (IQR 1-4.5) and the median BVAS in the MEPO group was 2 (IQR 1-5). In patients receiving RTX, the median BVAS declined both at 6 months (median 1, IQR 0-4.5) and at 12 months (median 0, IQR 0-2), and the frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 49%, 24%, 24%, and 3%, respectively. For the treatment of glucocorticoid (GC)-dependent asthma, patients who received MEPO had a much better GC-sparing effect and overall response than did patients who received OMA. The frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 15%, 33%, 48%, and 4%, respectively, in the OMA group and 78%, 10%, 8%, and 4%, respectively, in the MEPO group. Remission rates at 12 months were 76% and 82% among patients receiving MEPO at a doses of 100 mg and 300 mg, respectively. CONCLUSION: These results suggest that RTX could be effective in treating relapses of EGPA vasculitis. MEPO is highly effective with a good safety profile in patients with GC-dependent asthma. Our data suggest that 100 mg MEPO monthly could be an acceptable dosage for first-line therapy in selected instances of EGPA, recognizing, however, that this has not been compared to the validated dosage of 300 mg monthly.
OBJECTIVE: To describe the efficacy and safety of biologics for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: A retrospective European collaborative study was conducted in patients with EGPA who received treatment with biologics for refractory and/or relapsing disease. RESULTS: Among the 147 patients with EGPA included in the study, 63 received rituximab (RTX), 51 received mepolizumab (MEPO), and 33 received omalizumab (OMA). At the time of inclusion, the median Birmingham Vasculitis Activity Score (BVAS) was 8.5 (interquartile range [IQR] 5-13) in the RTX group, while the median BVAS in the OMA group was 2 (IQR 1-4.5) and the median BVAS in the MEPO group was 2 (IQR 1-5). In patients receiving RTX, the median BVAS declined both at 6 months (median 1, IQR 0-4.5) and at 12 months (median 0, IQR 0-2), and the frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 49%, 24%, 24%, and 3%, respectively. For the treatment of glucocorticoid (GC)-dependent asthma, patients who received MEPO had a much better GC-sparing effect and overall response than did patients who received OMA. The frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 15%, 33%, 48%, and 4%, respectively, in the OMA group and 78%, 10%, 8%, and 4%, respectively, in the MEPO group. Remission rates at 12 months were 76% and 82% among patients receiving MEPO at a doses of 100 mg and 300 mg, respectively. CONCLUSION: These results suggest that RTX could be effective in treating relapses of EGPA vasculitis. MEPO is highly effective with a good safety profile in patients with GC-dependent asthma. Our data suggest that 100 mg MEPO monthly could be an acceptable dosage for first-line therapy in selected instances of EGPA, recognizing, however, that this has not been compared to the validated dosage of 300 mg monthly.
Authors: Michael M Chen; Florence Roufosse; Sa A Wang; Srdan Verstovsek; Sandy R Durrani; Marc E Rothenberg; Thanai Pongdee; Joseph Butterfield; Timothy Lax; Michael E Wechsler; Miguel L Stein; Princess U Ogbogu; Basil M Kahwash; Sameer K Mathur; Dagmar Simon; Praveen Akuthota; Nicole Holland; Lauren Wetzler; JeanAnne M Ware; Canting Guo; Michael P Fay; Paneez Khoury; Amy D Klion; Bruce S Bochner Journal: J Allergy Clin Immunol Pract Date: 2022-02-15
Authors: Enrico Ammirati; Emanuele Bizzi; Giacomo Veronese; Matthieu Groh; Caroline M Van de Heyning; Jukka Lehtonen; Marc Pineton de Chambrun; Alberto Cereda; Chiara Picchi; Lucia Trotta; Javid J Moslehi; Antonio Brucato Journal: Front Med (Lausanne) Date: 2022-03-07
Authors: Allyson C Egan; Andreas Kronbichler; Irmgard Neumann; Alessandra Bettiol; Nicholas Carlson; Maria C Cid; Giacomo Emmi; Seerapani Gopaluni; Lorraine Harper; Thomas Hauser; Mark A Little; Raashid A Luqmani; Alfred Mahr; Mark McClure; Aladdin J Mohammad; Karl Emil Nelveg-Kristensen; Sophie Ohlsson; Chen Au Peh; Matthew Rutherford; Beatriz Sanchez Alamo; Jennifer Scott; Mårten Segelmark; Rona M Smith; Wladimir M Szpirt; Gunnar Tomasson; Giorgio Trivioli; Augusto Vaglio; Michael Walsh; Maria Wester Trejo; Kerstin Westman; Ingeborg M Bajema; David R W Jayne Journal: Kidney Int Rep Date: 2022-05-25
Authors: Wilma T Anselmo-Lima; Edwin Tamashiro; Fabrizio R Romano; Marcel M Miyake; Renato Roithmann; Eduardo M Kosugi; Márcio Nakanishi; Marco A Fornazieri; Thiago F P Bezerra; João F Mello; Marcus M Lessa; Richard L Voegels; Otávio B Piltcher; Eulalia Sakano; Fabiana C P Valera Journal: Braz J Otorhinolaryngol Date: 2021-04-03
Authors: Alessandra Bettiol; Maria Letizia Urban; Lorenzo Dagna; Vincent Cottin; Franco Franceschini; Stefano Del Giacco; Franco Schiavon; Thomas Neumann; Giuseppe Lopalco; Pavel Novikov; Chiara Baldini; Carlo Lombardi; Alvise Berti; Federico Alberici; Marco Folci; Simone Negrini; Renato Alberto Sinico; Luca Quartuccio; Claudio Lunardi; Paola Parronchi; Frank Moosig; Georgina Espígol-Frigolé; Jan Schroeder; Anna Luise Kernder; Sara Monti; Ettore Silvagni; Claudia Crimi; Francesco Cinetto; Paolo Fraticelli; Dario Roccatello; Angelo Vacca; Aladdin J Mohammad; Bernhard Hellmich; Maxime Samson; Elena Bargagli; Jan Willem Cohen Tervaert; Camillo Ribi; Davide Fiori; Federica Bello; Filippo Fagni; Luca Moroni; Giuseppe Alvise Ramirez; Mouhamad Nasser; Chiara Marvisi; Paola Toniati; Davide Firinu; Roberto Padoan; Allyson Egan; Benjamin Seeliger; Florenzo Iannone; Carlo Salvarani; David Jayne; Domenico Prisco; Augusto Vaglio; Giacomo Emmi Journal: Arthritis Rheumatol Date: 2021-12-30 Impact factor: 15.483