Favorable clinical efficacy of mepolizumab on the upper and lower airways in severe eosinophilic asthma: a 48-week pilot study

Kurosawa, Manabu; Ogawa, Emiko; Sutoh, E

doi:10.23822/eurannaci.1764-1489.94

Cited by 11 publications

(17 citation statements)

References 28 publications

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“…In conclusion, our preliminary results suggest that benralizumab, similar to mepolizumab and reslizumab, 31 – 33 as well as to the anti-IgE antibody omalizumab and to the dual IL-4/IL-13 receptor blocker dupilumab, 46 , 47 can extend its therapeutic actions to both upper and lower airways, unitedly involved in the pathophysiology of allergic diseases. However, because the main limitation of the present study is the small size of our patient population, further investigations are needed to eventually corroborate and validate such early findings in larger numbers of atopic subjects.…”

Section: Discussionmentioning

confidence: 68%

“…SNOT-22 score was reported to be improved by both these drugs. 31 – 33 Mepolizumab also improved nasal polyposis visual analog scale (VAS) score and endoscopic nasal polyp score, as well as significantly decreased the need for surgical treatment of nasal polyps. 31 , 32 …”

Section: Discussionmentioning

confidence: 98%

“…30 For instance, the humanized anti-IL-5 monoclonal antibody mepolizumab was shown to significantly improve SNOT-22 score, Lund-MacKay CT score and lung function in patients with severe eosinophilic asthma and nasal polyps. 31 Endoscopic evaluation also documented that a significant reduction of nasal polyp size was induced by either mepolizumab or reslizumab, 32,33 another humanized anti-IL-5 monoclonal antibody. Differently from mepolizumab and reslizumab which specifically interact with IL-5, the humanized monoclonal antibody benralizumab binds with its variable Fab fragments to the α subunit of IL-5 receptor (IL-5Rα), 28,29 thus preventing IL-5Rα activation by IL-5 itself.…”

Section: Introductionmentioning

confidence: 97%

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Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Lombardo

Pelaia

Ciriolo

et al. 2020

Int J Immunopathol Pharmacol

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The aim of this study has been to evaluate the efficacy of the IL-5 receptor blocker benralizumab on chronic rhinosinusitis with nasal polyposis (CRSwNP), associated with severe eosinophilic allergic asthma. Ten patients with severe eosinophilic allergic asthma and CRSwNP were enrolled. Sino-nasal outcome test (SNOT-22), numerical rating scale (NRS), endoscopic nasal polyp score, Lund Mackey CT (computed tomography) score, and blood eosinophil count were measured at baseline and after 24 weeks of treatment with benralizumab. All the above clinical, endoscopic, imaging, and hematological parameters significantly improved after 24 weeks of treatment with benralizumab. In particular, SNOT-22 decreased from 61.10 ± 17.20 to 26.30 ± 19.74 ( P < 0.001), NRS decreased from 7.20 ± 1.55 to 3.40 ± 2.22 ( P < 0.001), the endoscopic polyp nasal score decreased from 4.20 ± 1.32 to 2.50 ± 1.78 ( P < 0.001), the Lund-Mackay CT score decreased from 16.60 ± 5.50 to 6.90 ± 5.99 ( P < 0.001), and blood eosinophil count decreased from 807.3 ± 271.1 cells/μL to 0 cells/μL ( P < 0.0001). These results strongly suggest that benralizumab exerted a very effective therapeutic action on CRSwNP associated with severe asthma, thus improving nasal symptoms and decreasing polyp size.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 97%

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Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Lombardo

Pelaia

Ciriolo

et al. 2020

Int J Immunopathol Pharmacol

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“…Moreover, nasal polyposis may require recurrent surgical revisions [ 37 ]. There is real-life evidence of mepolizumab effectiveness in nasal polyposis and SEA [ 38 , 39 ]. In the present study, mepolizumab treatment induced a significant reduction in SNOT-22 score (Fig.…”

Section: Discussionmentioning

confidence: 99%

Real-life evidence of low-dose mepolizumab efficacy in EGPA: a case series

Detoraki

Tremante²,

Poto

et al. 2021

Respir Res

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Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, small vessel, necrotizing vasculitis. The disease is mainly characterized by hypereosinophilia and asthma with frequent sinonasal involvement, although multiple organs can be affected, including the heart, lungs, skin, gastrointestinal tract, kidneys, and nervous system. IL-5 production is pathogenetically central for the development of the disease by promoting proliferation, transvascular migration and functional activation of eosinophils. The degree of blood and tissue eosinophilia appears to be associated with disease pathogenesis and eosinophil depletion represents a promising treatment approach for EGPA. We prospectively evaluated the efficacy and safety of a low dose (100 mg q4w), 12-month course of mepolizumab, an anti-IL-5 monoclonal antibody, in eight patients with severe asthma and active EGPA. Patients were recruited by the tertiary care center of Clinical Immunology and Allergy, University of Naples Federico II. The following outcomes were assessed before (T0), and after 6 (T6) and 12 months (T12) of mepolizumab treatment: Birmingham Vasculitis Activity Score (BVAS), prednisone intake, Sino-Nasal Outcome Test (SNOT-22), Total Endoscopic Polyp Score (TENPS), Asthma Control Test (ACT), Forced Expiratory Volume one second (FEV1)%, blood eosinophilia. BVAS score significantly decreased showing a sharp reduction in disease activity score. Clinical improvements in terms of sinonasal scores and asthma symptoms were observed, in parallel with a drastic drop in eosinophil blood count. Prednisone intake was significantly reduced. In two patients, asthma exacerbations led to discontinuation in mepolizumab therapy after 6 and 12 months despite BVAS reduction. Mepolizumab treatment was well tolerated, and no severe adverse drug effects were registered. In conclusion, our 12-month real-life study suggests that mepolizumab may be beneficial and safe in active EGPA patients by improving disease activity score, sinonasal and asthma outcomes while reducing the burden of prednisone intake.

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“…After 6 months, patient was in steroid-free clinical remission with a stool frequency of 1-2 movements/day of normal feces (type 3 according to the Bristol stool chart) and a complete resolution of abdominal pain. BMI (Body Mass Index) reduced from 28 to 23 and none asthma exacerbation occurred during the first year of treatment and until the last follow-up evaluation (24 months) [6].…”

Section: Open Accessmentioning

confidence: 99%

Severe eosinophilic asthma and aspirin-exacerbated respiratory disease associated to eosinophilic gastroenteritis treated with mepolizumab: a case report

Colantuono

Pugliese

Mario

et al. 2020

Allergy Asthma Clin Immunol

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Background: Mepolizumab (MEP) is the first anti Interleukin (IL)-5 add-on therapy approved for the treatment of severe refractory eosinophilic asthma. Case presentation:We describe here the case of a 49 years-old woman with Aspirin-exacerbated respiratory disease (AERD), chronic rhinosinusitis, nasal polyposis and eosinophilic gastroenteritis successfully treated with MEP. Several laboratory and clinical items improved during therapy; moreover MEP showed to be useful as steroid sparing agent. Conclusions:This case supports that the use of mepolizumab can be effective also in other eosinophilic conditions different from asthma and this opens to new therapeutic perspectives. Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Favorable clinical efficacy of mepolizumab on the upper and lower airways in severe eosinophilic asthma: a 48-week pilot study

Cited by 11 publications

References 28 publications

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Real-life evidence of low-dose mepolizumab efficacy in EGPA: a case series

Severe eosinophilic asthma and aspirin-exacerbated respiratory disease associated to eosinophilic gastroenteritis treated with mepolizumab: a case report

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