Efficacy of mepolizumab treatment in oral corticosteroid-dependent severe eosinophilic asthma patients with chronic rhinosinusitis with nasal polyps: single center, real life study
The daily OCS dosage was reduced from baseline in all patients, and at week 24 OCS was discontinued in 40% of the patients baseline mean steroid dose: 9.2 ± 5.2 mg, 24th week: 1.3 ± 1.4 mg; P
📌 3 Key Takeaways
🎯
Objective & Hypothesis:Background/aim: Oral corticosteroid OCS -dependent severe eosinophilic asthma with chronic rhinosinusitis with nasal polyps SEACRSwNP would be a suitable phenotype for mepolizumab treatment.
📊
Key Findings & Data:Materials and methods: Baseline and 24th week results [daily OCS doses, asthma exacerbation frequency, asthma control test ACT scores, blood eosinophil levels, FEV1 values, and numerical analog scale NAS of CRSwNP symptoms] of patients who were treated for at least 24 weeks with mepolizumab were retrospectively evaluated and compared.
💡
Conclusion & Impact:The daily OCS dosage was reduced from baseline in all patients, and at week 24 OCS was discontinued in 40% of the patients baseline mean steroid dose: 9.2 ± 5.2 mg, 24th week: 1.3 ± 1.4 mg; P
Background/aim: Oral corticosteroid OCS -dependent severe eosinophilic asthma with chronic rhinosinusitis with nasal polyps SEACRSwNP would be a suitable phenotype for mepolizumab treatment. This study evaluated the short-term efficacy of mepolizumab treatment in OCS-dependent SEA-CRSwNP. Materials and methods: Baseline and 24th week results [daily OCS doses, asthma exacerbation frequency, asthma control test ACT scores, blood eosinophil levels, FEV1 values, and numerical analog scale NAS of CRSwNP symptoms] of patients who were treated for at least 24 weeks with mepolizumab were retrospectively evaluated and compared. Results: A total of 16 patients were enrolled in the study. Mepolizumab was discontinued in one patient due to side effects. The daily OCS dosage was reduced from baseline in all patients, and at week 24 OCS was discontinued in 40% of the patients baseline mean steroid dose: 9.2 ± 5.2 mg, 24th week: 1.3 ± 1.4 mg; P
YILMAZ, İ., TÜRK, M., BAHÇECİOĞLU, S. N., TUTAR, N., GÜLMEZ, İ. (2020). Efficacy of mepolizumab treatment in oral corticosteroid-dependent severe eosinophilic asthma patients with chronic rhinosinusitis with nasal polyps: single center, real life study. Turkish Journal of Medical Sciences, Cilt: 50 - Sayı: 2, 433–441. https://ajindex.com/articles/113441
Flood-Page P, Swenson C, Faiferman I, Matthews J, Williams M et al. International mepolizumab study group. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. American Journal of Respiratory and Critical Care Medicine 2007; 176: 1062-1071
Leckie MJ, ten Brinke A, Khan J, Diamant Z, O’Connor BJ et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyperresponsiveness, and the late asthmatic response. Lancet 2000; 356 (9248): 2144-2148
Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. New England Journal of Medicine 2014; 371: 1189-1197
Pavord ID, Korn S, Howarth P, Bleecker ER, Buhl R et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 2012; 380: 651-659
Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM et al. Mepolizumab treatment in patients with severe eosinophilic asthma. New England Journal of Medicine 2014; 371: 1198- 1207
Bousquet J, Chanez P, Lacoste JY, Barnéon G, Ghavanian N et al. Eosinophilic inflammation in asthma. New England Journal of Medicine 1990; 323(15): 1033-1039
Amelink M, de Groot JC, de Nijs SB, Lutter R, Zwinderman AH et al. Severe adult-onset asthma: a distinct phenotype. Journal of Allergy and Clinical Immunology 2013; 132: 336-341
Fajt ML, Wenzel SE. Asthma phenotypes and the use of biologic medications in asthma and allergic disease: the next steps toward personalized care. Journal of Allergy and Clinical Immunology 2015; 135: 299-310. 9. de Groot JC, ten Brinke A, Bel EHD. Management of the patient with eosinophilic asthma: a new era begins. European Respiratory Journal Open Research 2015; 1: 00024-02015
Moore WC, Meyers DA, Wenzel SE, Teague WG, Li H et al. Identification of asthma phenotypes using cluster analysis in the severe asthma research program. American Journal of Respiratory and Critical Care Medicine 2010; 181 (4): 315-323
Yilmaz İ, TerI M. Asthma management: a new phenotype based approach using presence of eosinophilia and allergy. Allergy 2017; 72 (10): 1587-1589
Yılmaz İ, Turk M, Bahcecioglu SN. Eosinophilic asthma with nasal polyposis march: is aspirin-exacerbated respiratory disease the last station? Journal of Allergy and Clinical Immunology: In Practice 2017; 5 (6): 1808-1809