Inhaled Corticosteroids Safety and Adverse Effects in Patients with Asthma

Heffler, Enrico; Madeira, Lorena Nascimento Girardi; Ferrando, Matteo; Puggioni, Francesca; Racca, Francesca; Malvezzi, Luca; Passalacqua, Giovanni; Canonica, Giorgio Walter

doi:10.1016/j.jaip.2018.01.025

Cited by 145 publications

(100 citation statements)

References 55 publications

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“…Previous studies have reported an influx of lymphocytes and eosinophils into alveolar tissue of asthma patients. 35 Moreover, mouse models suggest that blocking monocyte recruitment by targeting CCR2 reduces lung inflammation in asthma. Together, these findings identify the alveolar compartment as an active site of inflammation during severe asthma.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, the inhibition of monocytes is probably one of the multiple actions of inhaled corticosteroids in asthma. 35 Moreover, mouse models suggest that blocking monocyte recruitment by targeting CCR2 reduces lung inflammation in asthma. 8 Additionally, MMP10 antagonism might substantially reduce monocyte migration within the inflamed lungs.…”

Section: Migration Of Cells Within the Tissue Depends On Several Factorsmentioning

confidence: 99%

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Monocytes accumulate in the airways of children with fatal asthma

Eguiluz‐Gracia

Malmström

Dheyauldeen

et al. 2018

Clin Experimental Allergy

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Section: Discussionmentioning

confidence: 99%

Section: Migration Of Cells Within the Tissue Depends On Several Factorsmentioning

confidence: 99%

Monocytes accumulate in the airways of children with fatal asthma

Eguiluz‐Gracia

Malmström

Dheyauldeen

et al. 2018

Clin Experimental Allergy

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“…It is true that, in comparison with the regulatory trials, in real life, the high level of blood eosinophils count is essential to decide for the IL-5 antagonism strategy. The possibility of decreasing the OCS burden would be regarded as a relevant socio-economical advantage [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The North-Western Italian experience with anti IL-5 therapy amd comparison with regulatory trials

Bagnasco

Milanese

Rolla

et al. 2018

World Allergy Organization Journal

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BackgroundThe severe forms of asthma represent a major burden, because of severity of symptoms, costs and impact on everyday life. Recently, Mepolizumab (MEP) was approved and marketed for the treatment of hypereosinophilic severe asthma. This anti-IL-5 monoclonal antibody reduced exacerbation rates and oral corticosteroid (OCS) use in well selected patients. The aim of this study was to evaluate the characteristics of patients receiving MEP in a real-life setting. Thus, we describe a retrospective analysis of patients treated with MEP in six centres in North Western Italy, including those who participated in the main regulatory trials.MethodsThe baseline data, before prescription, from six North Western Italy severe asthma clinics, between June 1st 2017 and December 31st 2017, were evaluated. The collected real-life data were then compared with those of SIRUS, MENSA, DREAM and MUSCA trials.ResultsSixty-five patients were included (45% female; mean age 56 years; age range 19–84). Main observed differences with regulatory trials could be observed in eosinophils blood count at baseline, where the mean of our real-life patients (653 cells/μL) was overall higher than the one of all trials (240 cells/μL, 296 cells/μL, 253 cells/μL; p < 0.0001). The incidence of polyposis was also significantly higher in our sample (72% vs. 24%, 49%, 10%, 19%; p < 0.0001). The daily average dose of OCS was lower in our real-life patients (9 mg), if compared with SIRIUS (13.7 mg), MENSA (13.2) and MUSCA (13), and similar to the data published in DREAM (10.8).ConclusionsThe comparison of real-life patients' characteristics with regulatory trials, displayed several apparent discrepancies. The demographic and clinical aspects were similar in all groups, whereas other features (eosinophil count, pulmonary function FEV1%) differed. These data, for the first time, could represent a basis for a more accurate prescription of the drug.

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“…At the same time, the lower use of OCS, reported in most of studies carried out with OMZ and anti-IL5 therapies, limits the costs due to the OCS sideeffects. This is particularly true for patients who are on regular treatment 16 , but also an intermittent use is responsible for systemic side-effects 17 , as well as regular ICS at high dosages 18 . A further perspective that can be taken into account is the efficacy of the biologic treatments on concomitant comorbidities, which can further positively impact on costs.…”

mentioning

confidence: 99%