Background: There is a lack of information about the course of coronavirus disease 2019 (COVID-19) in patients with severe asthma who were treated with biologics. Some reports indicated that treatment with benralizumab, dupilumab, and omalizumab in patients with severe asthma was not associated with significant adverse effects during COVID-19.Methods: Asthma itself or the biologic agents used to treat asthma can have a positive effect on the course of COVID-19.There seem not to be any cases that specifically reported the use of mepolizumab in a patient who was infected with COVID.Results: We reported of a 55-year-old woman with a diagnosis of severe asthma for; 3 years and who was being treated withmepolizumab, with no evidence of loss of asthma control, at the time of contracting COVID-19 and who had been followed up inthe allergy clinic. In addition, there are no data on mepolizumab therapy in patients with elevated liver enzyme levels.Conclusion: With this case, we also reported that no adverse effects were observed during mepolizumab treatment in a patient with elevated liver enzyme levels.

No abstract

Background Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term modifying effect. Adherence is a key to ensure effectiveness. The objective of this study was, first of all, to evaluate the adherence with subcutaneous immunotherapy (SCIT) and to identify the main causes of SCIT withdrawal in real-life practice in our clinic. Secondly, to investigate to what extent COVID-19 pandemic altered our SCIT receiving patients’ treatment adherence behaviors and the factors that affected their decisions. Methods Retrospective analysis of the medical records of patients ages ≥18 years, who had started SCIT in January 2014 or later until September 2020 in our department for the diagnosis of allergic rhinitis, allergic asthma or venom allergy were included in the study. Adherence was determined as the accomplishment of three years of SCIT. Results A total of 124 patients (72 female [58.1%]; median age, 35 [19-77] years) were included. The adherence rate to SCIT in our tertiary center’s real-life setting was 56.25% with a follow-up duration of 3 years before COVID-19 pandemic. Dose modification, defined as reducing patient's planned SCIT dose due to a systemic allergic/large local reaction or missed injection, and its frequency, which is the number of dose adjustments done throughout the SCIT, was found to be the only factor related to nonadherence. But with the pandemic only in 6 months, among 63 patients receiving SCIT, 15 patients (23.81%) dropped out and the most common reason was fear of being infected with COVID-19 virus during receiving SCIT in hospital (93.33%). The only independent predictor of drop-out during COVID-19 pandemic was short duration of AIT (p=0.012). When we compare the dropped-out cases before and after the start of pandemic AIT duration was significantly shorter in pandemic period (p= 0.005). Conclusion Adherence rate to SCIT in our real-world setting study was 56.25% before COVID-19 pandemic. Our results indicated that patients requiring dose modification were more prone to be non-adherent. Approximately a quarter of patients dropped-out with the start of pandemic, almost all due to fear of being infected during receiving SCIT in hospital. Since short SCIT follow-up time was found to be the only risk factor for drop-out during COVID-19 pandemic, we believe that patients who are in the early phases of their treatment should be observed more closely and their concerns should be answered by their doctors.

Amaç: Mepolizumabın astım alevlenmeleri, kan eozinofilleri, oral steroid bağımlılığı ve astım kontrolü üzerindeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışma, retrospektif analiz ile elde edilen gerçek yaşam verilerinden oluşturulmuş klinik gözlemsel bir çalışmadır. Kliniğimizde dört haftada bir 100 mg deri altı mepolizumab başlanan ve en az 16 hafta tedavi gören hastalar çalışmaya alındı. Bulgular: Ağır eozinofilik astımı olan 34 hasta çalışmaya dahil edildi. Ağır eozinofilik astımı olan hastalarda mepolizumab tedavisinin astım alevlenmelerinin sayısında, oral kortikosteroid idame ihtiyacında, kan eozinofil sayılarında ve akciğer fonksiyonlarında ve astım kontrol testi puanlarında iyileşme ile sonuçlandığını bulduk. 6 ayda mepolizumab tedavisine yanıt verenlerin ve süper yanıt verenlerin oranı sırasıyla %75 ve %17,9’du ve sonuç olarak genel yanıt oranı %92,9’du. Tedavinin ilk yılında, süper yanıt verenlerin oranı %58,3’e yükseldi ve genel yanıt oranı %91,7 oldu. İkinci yılda yanıt verenlerin ve süper yanıt verenlerin oranı sırasıyla %7,7 ve %84,6 ve genel yanıt oranı %92,3’tü. 3 yılda, genel yanıt oranı %100’e yükselmişti. Sonuç: Ağır eozinofilik astımı olan hastalarda mepolizumab tedavisinin sonuçlarını değerlendirdiğimiz tek merkezli çalışmamızın sonuçları, gerçek yaşam ortamında önceki çalışmalarda yayınlanan klinik, hematolojik ve fonksiyonel bulguları doğruladı.

Introduction Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7–13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. Case report A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. Management & outcome With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Discussion Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.