Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis
| العنوان: | Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis |
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| المؤلفون: | Takanori Numata, Takeo Ishikawa, Hirofumi Utsumi, Hiromichi Hara, Kenji Kobayashi, Mitsuo Hashimoto, Haruhiko Yanagisawa, Jun Araya, Kazuyoshi Kuwano, Katsutoshi Nakayama, Shunsuke Minagawa |
| المصدر: | BMC Pulmonary Medicine BMC Pulmonary Medicine, Vol 19, Iss 1, Pp 1-9 (2019) |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Exacerbation, Omalizumab, Antibodies, Monoclonal, Humanized, Severity of Illness Index, Pulmonary function testing, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, Maintenance therapy, Japan, Internal medicine, Eosinophilic, Eosinophilia, Medicine, Humans, 030212 general & internal medicine, Anti-Asthmatic Agents, Sinusitis, Mepolizumab, Asthma, Retrospective Studies, Rhinitis, lcsh:RC705-779, business.industry, Maintenance dose, Eosinophilic chronic rhinosinusitis, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, Logistic Models, Treatment Outcome, 030228 respiratory system, Chronic Disease, Multivariate Analysis, Disease Progression, Female, Staphylococcus enterotoxin, business, Predictive factor, medicine.drug, Research Article |
| الوصف: | Background Several major randomized control studies have demonstrated that mepolizumab, an anti-IL-5 monoclonal antibody, is effective for patients with severe eosinophilic asthma who show exacerbation or require systemic corticosteroid maintenance therapy. However, the predictive factors of the response to mepolizumab other than blood eosinophil count are unclear in clinical practice. Objective To elucidate the predictive factors of the response to mepolizumab for patients with severe eosinophilic asthma. Methods From July 2016 to December 2017, 28 patients with severe asthma received mepolizumab in our hospital. To determine the predictive factors, we retrospectively evaluated patient characteristics, comorbidities, biomarkers, pulmonary function, maintenance dose of systemic corticosteroids and number of exacerbations. Results The response rate to mepolizumab treatment was 70% (19/27; one pregnant woman was excluded from analysis). Compared with 11 patients without eosinophilic chronic rhinosinusitis (ECRS), 16 patients with ECRS showed significantly improved systemic corticosteroid-sparing effects [− 71.3 ± 37.0% vs − 10.7 ± 20.1%, P = 0.006], change from baseline FeNO [− 19 ± 57 (%) vs 30 ± 77 (%), P = 0.023] and symptoms [14 patients (88%) vs five patients (45%), P = 0.033]. ECRS was identified as a predictive factor of the response to mepolizumab in a multivariate logistic regression analysis [odds ratio = 22.5, 95% CI (1.5–336), P = 0.024]. Of the eight patients previously administered omalizumab, five responded to mepolizumab. Staphylococcus aureus enterotoxin B IgE results were negative in 80% of responders (P = 0.14). Conclusion Both groups showed improved symptom scores and a decreased number of exacerbations. Mepolizumab substantially improved the clinical variables of patients with eosinophilic asthma complicated with ECRS. |
| تدمد: | 1471-2466 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f92bbaa34373bb65873c9f9b44140ad0Test https://pubmed.ncbi.nlm.nih.gov/31606052Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f92bbaa34373bb65873c9f9b44140ad0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712466 |
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