scholarly journals Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1550
Author(s):  
Angelantonio Maglio ◽  
Carolina Vitale ◽  
Simona Pellegrino ◽  
Cecilia Calabrese ◽  
Maria D’Amato ◽  
...  
Keyword(s):  
Lung Function ◽  
Peripheral Blood ◽  
Real Life ◽  
Small Airway ◽  
Airflow Limitation ◽  
Small Airways ◽  
Phenotypic Characteristics ◽  
Eosinophilic Asthma ◽  
Peripheral Blood Eosinophil ◽  
Severe Eosinophilic Asthma

Severe eosinophilic asthma (SEA) is associated with high peripheral blood and airway eosinophilia, recurrent disease exacerbations and severe airflow limitation. Eosinophilic inflammation is also responsible for small airway disease (SAD) development. SEA patients experience poor disease control and response to standard therapy and are prime candidates for anti-IL5 biologicals, such as mepolizumab, but the effect of treatment on SAD is unclear. We investigated the effect of mepolizumab on lung function in SEA patients, focusing on SAD parameters, and searched for an association between patients’ phenotypic characteristics and changes in small airways function. In this real-life study, data from 105 patients with SEA were collected at baseline and after 6, 12 and 18 months of mepolizumab treatment. Along with expected improvements in clinical and lung function parameters brought by Mepolizumab treatment, FEF2525-75% values showed a highly significant, gradual and persistent increase (from 32.7 ± 18.2% at baseline to 48.6 ± 18.4% after 18 months) and correlated with ACT scores at 18 months (r = 0.566; p ≤ 0.0001). A patient subgroup analysis showed that changes in FEF25-75% values were higher in patients with a baseline peripheral blood eosinophil count ≥400 cells/μL and oral corticosteroid use. Mepolizumab significantly improves small airway function. This effect correlates with clinical benefits and may represent an accessible parameter through which to evaluate therapeutic response. This study provides novel insights into the phenotypic characteristics associated with the improved functional outcome provided by mepolizumab treatment.

scholarly journals Mepolizumab effectiveness in patients with severe eosinophilic asthma and co-presence of bronchiectasis: a real-world retrospective pilot study

2020 ◽  
Author(s):  
Claudia Crimi ◽  
Raffaele Campisi ◽  
Santi Nolasco ◽  
Giulia Cacopardo ◽  
Rossella Intravaia ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lung Function ◽  
Real Life ◽  
Specific Effect ◽  
List Type ◽  
Asthma Control Test ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Asthma Symptoms ◽  
Blood Eosinophils

AbstractBackgroundThe association of bronchiectasis (BE) in patients with severe eosinophilic asthma (SEA) is quite frequent. Mepolizumab is a well-recognized treatment for SEA; we aim to evaluate its effectiveness in SEA patients with and without BE in real-life.MethodsWe performed a single-center retrospective pilot study, including patients with SEA treated with mepolizumab for one year. Asthma control test (ACT), lung function, annual exacerbations rate, oral corticosteroid dosage, FeNO, chronic mucous secretions, blood and sputum eosinophils were recorded at baseline and after 6 and 12 months.Resultswe included 32 patients (mean age: 52.3±10, 59% female). 50% showed co-presence of bronchiectasis, (SEA+BE). Significant improvements were found in ACT [(13.8±4.6 to 20.7±4.1, p=0.0009) and (13±4.8 to 20.7±4.6, p=0.0003)], annual exacerbations rate [from 7 (4-12) to 0 (0.00-0.75) and from 8 (4-12) to 0 (0-1), p<0.0001], and blood eosinophils count [748 cells/μL (400-1250) vs. 84 cells/μL (52.5-100), and from 691 cells/μL (405-798) vs. 60 cells/μL (41-105), p<0.0001] in SEA and SEA+BE group respectively, already after 6 months of treatment. A reduction in daily oral corticosteroids intake at 12 months was shown [from 15 mg (0-25) to 0 mg (0-0), p=0.003 and from 8.8 mg (0-25) to 0 mg (0-0) (p=0.01)] in both SEA and SEA+BE, respectively. Similar results were found, comparing SEA+BE patients based on the severity of bronchiectasis.ConclusionsMepolizumab effectively improves asthma symptoms control, reducing annual exacerbations and corticosteroid intake in all patients with SEA, even in the subgroup with coexisting bronchiectasis, independently of their severity.HighlightsMepolizumab is effective in the treatment of severe eosinophilic asthma (SEA) in clinical trials and real-life studies.Bronchiectasis is a frequent comorbidity in patients with severe eosinophilic asthma.Mepolizumab proved to be effective in improving asthma symptoms control, mucus hypersecretion, lung function, and reducing sputum and blood eosinophils, corticosteroids dependency and annual exacerbations both in severe eosinophilic asthma patients with or without co-presence of bronchiectasis.Mepolizumab showed to be effective in patients with asthma and co-presence of bronchiectasis, regardless of BE severity.Assessing the co-presence and severity of bronchiectasis may help clinicians select the right biologic for a prompt treatment-specific effect.

scholarly journals Effectiveness of Benralizumab in Improving the Quality of Life of Severe Eosinophilic Asthmatic Patients: Our Real-Life Experience

2021 ◽  
Vol 12 ◽  
Author(s):  
Giulia Scioscia ◽  
Giovanna Elisiana Carpagnano ◽  
Carla Maria Irene Quarato ◽  
Donato Lacedonia ◽  
Sonia Santamaria ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Asthma Control ◽  
Severe Asthma ◽  
Life Experience ◽  
Real Life ◽  
Eosinophilic Inflammation ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma

Background: Severe eosinophilic asthma decreases lung function and causes worsen symptoms, often forcing recurrent maintenance corticosteroid use. The aim of our real-life study was to evaluate the effectiveness of an add-on treatment with benralizumab in patients with severe eosinophilic asthma, paying particular attention to the impact on their quality of life (QoL).Materials and methods: In this prospective study, 10 outpatients with severe eosinophilic asthma were added-on with benralizumab and followed-up in our severe asthma clinic after 12 and 24 weeks. At each patient visit, pre-bronchodilator FEV1 and inflammatory markers were recorded. Variations in asthma symptoms control and QoL perception was assessed by validated questionnaires.Results: All the subjects experienced a marked reduction of nocturnal and diurnal symptoms over time and were able to stop using OCS, as documented by the improvement in Asthma control test (ACT) and Asthma Control Questionnaire score. Similarly, we recorded a statistically significant increase in patient’s QoL perception in EQ-VAS, EQ-5D-3L and Asthma Quality of Life Questionnaire (AQLQ) assessment (p &lt; 0.05). Simultaneously we recorded a significant reduction in eosinophilic inflammation, an improvement in pre-bronchodilator FEV1. These results appear to be in line with those already obtained in the previous randomized controlled trials (RCTs).Conclusion: Our 24-weeks real life experience supports the effectiveness of an add-on treatment with benralizumab in reducing eosinophilic inflammation and OCS-use, increasing lung function and improving control of nocturnal and diurnal symptoms, as well as restoring severe asthma patients to a better QoL.

Results in clinical practice in the treatment of severe eosinophilic asthma with mepolizumab: a real-life study

2021 ◽  
pp. 1-7
Author(s):  
Ana Isabel Enríquez-Rodríguez ◽  
Tamara Hermida Valverde ◽  
Pedro Romero Álvarez ◽  
Francisco Julián López-González ◽  
Jose Antonio Gullón Blanco ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Real Life ◽  
Eosinophilic Asthma ◽  
Life Study ◽  
Severe Eosinophilic Asthma ◽  
Real Life Study

Outcomes of Peripheral Blood Eosinophilia in Hospitalized Exacerbations of COPD

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Samar El Sharkawy ◽  
Riham Hazem Raafat ◽  
Reem Osama Mohamed Ahmed Qassem
Keyword(s):  
Peripheral Blood ◽  
Diagnostic Performance ◽  
Leukocyte Count ◽  
Airflow Limitation ◽  
Total Leukocyte Count ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Peripheral Blood Eosinophil ◽  
Copd Exacerbations ◽  
Cutoff Points

Abstract Background The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines define COPD as a disease state characterized by airflow limitation that is not fully reversible, is usually progressive, and is associated with an abnormal inflammatory response of the lungs to inhaled noxious particles or gases. Objective To identify outcomes of patients with eosinophilic COPD exacerbations requiring hospital admission. Patients and Methods This study is a prospective cohort study that was conducted on two groups of total 60 patients recruited from Ain Shams University hospitals between October 2019 and July 2020. Group 1: Eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is ≥ 200 cells/µL and/or ≥2% of the total leukocyte count Group 2: Non-eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is &lt; 200 cells/µL and/or &lt; 2% of the total leukocyte count. Results There was significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, percent (%) and NLR cutoff points had high characteristics (highest in NLR ≥3.1 at discharge) in predicting readmission at 6-month among eosinophilic group. Diagnostic performance of Eosinophils count, percent (%) and NLR were assessed. Eosinophils count, percent (%) and NLR had significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, % and NLR cutoff points had high characteristics (highest in NLR ≥2.1 at discharge) in predicting readmission at 6month among non-eosinophilic group. Conclusion Eosinophils can be used as a prognostic marker in non-infective COPD exacerbations. Validity of eosinophil count and percent as a prognostic parameter in COPD exacerbation can be increased by combining with other parameters for example NLR.

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