Effectiveness and safety of anti-IL-5/Rα biologics in eosinophilic granulomatosis with polyangiitis : a two-year multicenter observational study
Copyright © 2023 Nolasco, Portacci, Campisi, Buonamico, Pelaia, Benfante, Triggiani, Spadaro, Caiaffa, Scioscia, Detoraki, Valenti, Papia, Tomasello, Crimi, Scichilone, Pelaia, Carpagnano and Crimi..
Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterized by asthma, systemic manifestations, and blood and tissue eosinophilia.
Objective: To assess the effectiveness and safety of mepolizumab (anti-IL-5) and benralizumab (anti-IL-5Rα) in EGPA for 24 months.
Methods: We conducted a multicenter observational study, including patients with EGPA treated with anti-IL-5/Rα biologics in 9 Italian specialized facilities. Systemic disease activity, remission and relapse rate were evaluated from 3 to 24 months after treatment initiation. Respiratory outcomes, hematological parameters, corticosteroid (OCS) and immunosuppressants consumption were also assessed.
Results: 49 patients with relapsing-refractory EGPA were included [26 (53.1%) benralizumab 30mg, 20 (40.8%) mepolizumab 100mg, 3 (6.1%) mepolizumab 300mg]. Overall, 38.8% and 57.1% achieved remission after 12 and 24 months, respectively (69.2% benralizumab and 43.5% mepolizumab). Lower OCS intake and higher blood eosinophil count at baseline were associated with remission at 24 months. Both biologics exerted beneficial effects on severe asthma outcomes. Indeed, 61.2% (61.5% benralizumab and 60.8% mepolizumab) remained exacerbation-free during treatment. Lung function parameters showed improvements in the overall cohort (all p<0.05), but began to decline from month 12, especially with mepolizumab. Marked reduction in blood eosinophils was registered with mepolizumab (p<0.0001), while benralizumab depleted both eosinophils (p<0.0001) and basophils (p<0.0001). In general, 69.6% (76% benralizumab and 61.9% mepolizumab) of OCS-dependent patients lowered their daily dose by 75%, while 28.3% discontinued these drugs. Immunosuppressants were suspended in 88.2% of cases. Adverse events were reported in 8.2% of patients.
Conclusions: These real-world data suggest that anti-IL-5/Rα biologics are effective and safe in the long-term as add-on treatments for patients with EGPA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Frontiers in immunology - 14(2023) vom: 15., Seite 1204444 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nolasco, Santi [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 18.07.2023 Date Revised 18.07.2023 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.3389/fimmu.2023.1204444 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359584209 |
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| 245 | 1 | 0 | |a Effectiveness and safety of anti-IL-5/Rα biologics in eosinophilic granulomatosis with polyangiitis |b a two-year multicenter observational study |
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| 500 | |a Date Revised 18.07.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Nolasco, Portacci, Campisi, Buonamico, Pelaia, Benfante, Triggiani, Spadaro, Caiaffa, Scioscia, Detoraki, Valenti, Papia, Tomasello, Crimi, Scichilone, Pelaia, Carpagnano and Crimi. | ||
| 520 | |a Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterized by asthma, systemic manifestations, and blood and tissue eosinophilia | ||
| 520 | |a Objective: To assess the effectiveness and safety of mepolizumab (anti-IL-5) and benralizumab (anti-IL-5Rα) in EGPA for 24 months | ||
| 520 | |a Methods: We conducted a multicenter observational study, including patients with EGPA treated with anti-IL-5/Rα biologics in 9 Italian specialized facilities. Systemic disease activity, remission and relapse rate were evaluated from 3 to 24 months after treatment initiation. Respiratory outcomes, hematological parameters, corticosteroid (OCS) and immunosuppressants consumption were also assessed | ||
| 520 | |a Results: 49 patients with relapsing-refractory EGPA were included [26 (53.1%) benralizumab 30mg, 20 (40.8%) mepolizumab 100mg, 3 (6.1%) mepolizumab 300mg]. Overall, 38.8% and 57.1% achieved remission after 12 and 24 months, respectively (69.2% benralizumab and 43.5% mepolizumab). Lower OCS intake and higher blood eosinophil count at baseline were associated with remission at 24 months. Both biologics exerted beneficial effects on severe asthma outcomes. Indeed, 61.2% (61.5% benralizumab and 60.8% mepolizumab) remained exacerbation-free during treatment. Lung function parameters showed improvements in the overall cohort (all p<0.05), but began to decline from month 12, especially with mepolizumab. Marked reduction in blood eosinophils was registered with mepolizumab (p<0.0001), while benralizumab depleted both eosinophils (p<0.0001) and basophils (p<0.0001). In general, 69.6% (76% benralizumab and 61.9% mepolizumab) of OCS-dependent patients lowered their daily dose by 75%, while 28.3% discontinued these drugs. Immunosuppressants were suspended in 88.2% of cases. Adverse events were reported in 8.2% of patients | ||
| 520 | |a Conclusions: These real-world data suggest that anti-IL-5/Rα biologics are effective and safe in the long-term as add-on treatments for patients with EGPA | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
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| 650 | 4 | |a IL-5 | |
| 650 | 4 | |a benralizumab | |
| 650 | 4 | |a eosinophilic granulomatosis with polyangiitis | |
| 650 | 4 | |a mepolizumab | |
| 650 | 4 | |a oral corticosteroid | |
| 650 | 4 | |a remission | |
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| 700 | 1 | |a Buonamico, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Pelaia, Corrado |e verfasserin |4 aut | |
| 700 | 1 | |a Benfante, Alida |e verfasserin |4 aut | |
| 700 | 1 | |a Triggiani, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Spadaro, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Caiaffa, Maria Filomena |e verfasserin |4 aut | |
| 700 | 1 | |a Scioscia, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Detoraki, Aikaterini |e verfasserin |4 aut | |
| 700 | 1 | |a Valenti, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Papia, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Tomasello, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Crimi, Nunzio |e verfasserin |4 aut | |
| 700 | 1 | |a Scichilone, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Pelaia, Girolamo |e verfasserin |4 aut | |
| 700 | 1 | |a Carpagnano, Giovanna Elisiana |e verfasserin |4 aut | |
| 700 | 1 | |a Crimi, Claudia |e verfasserin |4 aut | |
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