Mepolizumab effectiveness on small airway obstruction, corticosteroid sparing and maintenance therapy step-down in real life
Copyright © 2020 Elsevier Ltd. All rights reserved..
BACKGROUND: Mepolizumab (MEP) has been recently introduced to treat severe eosinophilic asthma. Trials have demonstrated a significant effectiveness in this asthma phenotype. We evaluated MEP efficacy on lung function, symptoms, asthma exacerbations, biologic markers, steroid dependence and controller treatment level in real-life.
METHODS: We retrospectively analyzed 134 severe asthmatics (61 males; mean age 58.3 ± 11; mean FEV1%:72 ± 21), treated with MEP for at least 6 months (mean duration:10.9 ± 3.7 months).
RESULTS: FEV1% improved significantly after MEP. Mean FEF25-75 also increased from 37.4 ± 25.4% to 47.2 ± 27.2% (p < 0.0001). Mean baseline blood eosinophil level was 712 ± 731/μL (8.4 ± 5.2%) decreasing to 151 ± 384/μL (1.6 ± 1.6%) (p < 0.0001), FENO levels decreased likewise. MEP treatment also led to a significant ACT improvement (mean pre:14.2 ± 4.4; mean post:20.5 ± 28) and exacerbations significantly fell from 3.8 ± 1.9 to 0.8 ± 1.1 (p < 0.0001). 74% of patients were steroid-dependent before MEP. 45.4% and 46.4% of them showed a suspension and dose reduction respectively (p < 0.0001). A significant number reduced also ICS doses. Only 67% of subjects used SABA as needed before MEP, falling to 20% after MEP. About 40% of patients highlighted a maintenance therapy step-down. Subjects showing an omalizumab treatment failure before MEP had a similar positive response when compared with omalizumab untreated patients.
CONCLUSION: In real-life, MEP improved significantly all outcomes even small airway obstruction, suggesting its possible role also in distal lung region treatment. Furthermore, it demonstrated its high effectiveness in OC/ICS-sparing, in reducing SABA as needed and in stepping-down maintenance therapy. MEP is a valid alternative for patients with previous omalizumab treatment failure.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:61 |
|---|---|
| Enthalten in: |
Pulmonary pharmacology & therapeutics - 61(2020) vom: 24. Apr., Seite 101899 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Sposato, Bruno [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 05.04.2021 Date Revised 05.04.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.pupt.2020.101899 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM305695002 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM305695002 | ||
| 003 | DE-627 | ||
| 005 | 20231225121733.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.pupt.2020.101899 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1018.xml |
| 035 | |a (DE-627)NLM305695002 | ||
| 035 | |a (NLM)31972327 | ||
| 035 | |a (PII)S1094-5539(19)30294-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Sposato, Bruno |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mepolizumab effectiveness on small airway obstruction, corticosteroid sparing and maintenance therapy step-down in real life |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 05.04.2021 | ||
| 500 | |a Date Revised 05.04.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Mepolizumab (MEP) has been recently introduced to treat severe eosinophilic asthma. Trials have demonstrated a significant effectiveness in this asthma phenotype. We evaluated MEP efficacy on lung function, symptoms, asthma exacerbations, biologic markers, steroid dependence and controller treatment level in real-life | ||
| 520 | |a METHODS: We retrospectively analyzed 134 severe asthmatics (61 males; mean age 58.3 ± 11; mean FEV1%:72 ± 21), treated with MEP for at least 6 months (mean duration:10.9 ± 3.7 months) | ||
| 520 | |a RESULTS: FEV1% improved significantly after MEP. Mean FEF25-75 also increased from 37.4 ± 25.4% to 47.2 ± 27.2% (p < 0.0001). Mean baseline blood eosinophil level was 712 ± 731/μL (8.4 ± 5.2%) decreasing to 151 ± 384/μL (1.6 ± 1.6%) (p < 0.0001), FENO levels decreased likewise. MEP treatment also led to a significant ACT improvement (mean pre:14.2 ± 4.4; mean post:20.5 ± 28) and exacerbations significantly fell from 3.8 ± 1.9 to 0.8 ± 1.1 (p < 0.0001). 74% of patients were steroid-dependent before MEP. 45.4% and 46.4% of them showed a suspension and dose reduction respectively (p < 0.0001). A significant number reduced also ICS doses. Only 67% of subjects used SABA as needed before MEP, falling to 20% after MEP. About 40% of patients highlighted a maintenance therapy step-down. Subjects showing an omalizumab treatment failure before MEP had a similar positive response when compared with omalizumab untreated patients | ||
| 520 | |a CONCLUSION: In real-life, MEP improved significantly all outcomes even small airway obstruction, suggesting its possible role also in distal lung region treatment. Furthermore, it demonstrated its high effectiveness in OC/ICS-sparing, in reducing SABA as needed and in stepping-down maintenance therapy. MEP is a valid alternative for patients with previous omalizumab treatment failure | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Effectiveness | |
| 650 | 4 | |a FEF(25-75) | |
| 650 | 4 | |a Mepolizumab | |
| 650 | 4 | |a Oral corticosteroids | |
| 650 | 4 | |a Real-life | |
| 650 | 4 | |a Severe asthma | |
| 650 | 4 | |a Small airways | |
| 650 | 4 | |a Step-down | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Anti-Asthmatic Agents |2 NLM | |
| 650 | 7 | |a Antibodies, Monoclonal, Humanized |2 NLM | |
| 650 | 7 | |a mepolizumab |2 NLM | |
| 650 | 7 | |a 90Z2UF0E52 |2 NLM | |
| 700 | 1 | |a Camiciottoli, Gianna |e verfasserin |4 aut | |
| 700 | 1 | |a Bacci, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Scalese, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Carpagnano, Giovanna Elisiana |e verfasserin |4 aut | |
| 700 | 1 | |a Pelaia, Corrado |e verfasserin |4 aut | |
| 700 | 1 | |a Santus, Pierachille |e verfasserin |4 aut | |
| 700 | 1 | |a Maniscalco, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a Masieri, Simonetta |e verfasserin |4 aut | |
| 700 | 1 | |a Corsico, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Scichilone, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Baglioni, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Murgia, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Folletti, Ilenia |e verfasserin |4 aut | |
| 700 | 1 | |a Bardi, Giulio |e verfasserin |4 aut | |
| 700 | 1 | |a Grosso, Amelia |e verfasserin |4 aut | |
| 700 | 1 | |a Cameli, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Latorre, Manuela |e verfasserin |4 aut | |
| 700 | 1 | |a Musarra, Antonino |e verfasserin |4 aut | |
| 700 | 1 | |a Bargagli, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Ricci, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Pelaia, Girolamo |e verfasserin |4 aut | |
| 700 | 1 | |a Paggiaro, Pierluigi |e verfasserin |4 aut | |
| 700 | 1 | |a Rogliani, Paola |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pulmonary pharmacology & therapeutics |d 1997 |g 61(2020) vom: 24. Apr., Seite 101899 |w (DE-627)NLM092899625 |x 1522-9629 |7 nnns |
| 773 | 1 | 8 | |g volume:61 |g year:2020 |g day:24 |g month:04 |g pages:101899 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.pupt.2020.101899 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 61 |j 2020 |b 24 |c 04 |h 101899 | ||