0000000000298319
AUTHOR
Cecilia Calabrese
Author_Response_1 – Supplemental material for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy
Supplemental material, Author_Response_1 for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy by Giovanna Elisiana Carpagnano, Corrado Pelaia, Maria D’Amato, Nunzio Crimi, Nicola Scichilone, Giulia Scioscia, Onofrio Resta, Cecilia Calabrese, Girolamo Pelaia, Carla Maria Irene Quarato and Maria Pia Foschino Barbaro in Therapeutic Advances in Respiratory Disease
Oral CorticoSteroid sparing with biologics in severe asthma: A remark of the Severe Asthma Network in Italy (SANI)
According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored al…
Reviewer_2_v.1 – Supplemental material for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy
Supplemental material, Reviewer_2_v.1 for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy by Giovanna Elisiana Carpagnano, Corrado Pelaia, Maria D’Amato, Nunzio Crimi, Nicola Scichilone, Giulia Scioscia, Onofrio Resta, Cecilia Calabrese, Girolamo Pelaia, Carla Maria Irene Quarato and Maria Pia Foschino Barbaro in Therapeutic Advances in Respiratory Disease
Validation of Murray sputum purulence scale in the Italian Registry of Bronchiectasis (IRIDE)
Introduction: Murray sputum colour chart stratifies patients according to the presence of mucous (M), muco-purulent (MP) or purulent (P) sputum, and has not been validated in Bx yet. We aimed to validate this scale across a large Italian cohort of Bx patients. Methods: A secondary analysis of the IRIDE database was conducted including adults with Bx and daily sputum production enrolled across 13 Italian centres between 2014 and 2017. M vs. MP vs. P sputum producers were identified and clinical, functional and microbiological data were collected. Clinical outcomes during a two-year follow up period were evaluated in the Monza and Milan cohorts. A sensitivity analysis excluding COPD patients …
Cost-effectiveness of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
Background: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ quality of life and increased healthcare spending. Objectives: To assess the clinical and economic impact of switching from omalizumab (OMA) to mepolizumab (MEP) in patients eligible for both biologics but not optimally controlled with OMA. Methods: Uncontrolled patients referred to 6 asthma clinics in south of Italy switched from OMA to MEP, were enrolled and followed-up to Jan 2020. Clinical information included blood eosinophil count, asthma control test (ACT), pulmonary function, IgE, exhaled nitric oxide (FeNO), OCS intake, drugs, exacerbations/hospitalizations, …
Effectiveness of benralizumab in severe eosinophilic asthma: Distinct sub-phenotypes of response identified by cluster analysis
Background: Benralizumab is effective in severe eosinophilic asthma (SEA), but suboptimal responses are observed in some patients. Although several factors have been associated with benralizumab response, no cluster analysis has yet been undertaken to identify different responsiveness sub-phenotypes. Objective: To identify SEA sub-phenotypes with differential responsiveness to benralizumab. Methods: One hundred and five patients diagnosed with SEA who had completed 6 months of benralizumab treatment were included in a hierarchical cluster analysis based on a set of clinical variables that can be easily collected in routine practice (age, age at disease onset, disease length, allergen sensit…
Switching from omalizumab to mepolizumab: real-life experience from Southern Italy.
Background: Current availability of several biologic treatments for severe asthma makes it possible to choose the most appropriate for each patient. Sometimes a good percentage of patients with severe asthma may be eligible for biologics that target either the allergic phenotype or the eosinophilic one, but not all respond to that selected as first choice. The aim of our real-life study was to assess whether, for patients with severe eosinophilic allergic asthma, not previously controlled by the anti-IgE omalizumab, the shift to another biologic targeting interleukin-5, such as mepolizumab, may represent a good therapeutic choice. Methods: A total of 41 consecutive patients with severe, per…
Benralizumab: From the Basic Mechanism of Action to the Potential Use in the Biological Therapy of Severe Eosinophilic Asthma
Asthma is a very frequent chronic airway disease that includes many different clinical phenotypes and inflammatory patterns. In particular, eosinophilic bronchial inflammation is often associated with allergic as well as nonallergic asthma. The most important cytokine involved in the induction, maintenance, and amplification of airway eosinophilia in asthma is interleukin-5 (IL-5), released by both T helper 2 (Th2) lymphocytes and group 2 innate lymphoid cells (ILC2). Hence, IL-5 and its receptor are suitable targets for selective biologic drugs which can play a key role in add-on treatment of severe eosinophilic asthma refractory to corticosteroids. Within such a context, the anti-IL-5 mon…
Benralizumab Effectiveness in Severe Eosinophilic Asthma with and without Chronic Rhinosinusitis with Nasal Polyps: A Real-World Multicenter Study
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) affects around 60% of patients with severe eosinophilic asthma (SEA). Benralizumab was recently approved for SEA add-on treatment. Objective: To assess the real-world effectiveness of benralizumab in SEA with or without CRSwNP. Methods: We conducted a multicenter observational study, including patients with SEA treated with benralizumab for 24 weeks in 12 Italian specialized facilities. Asthma exacerbations, Asthma Control Test (ACT), lung function, oral corticosteroid (OCS) dosage, and eosinophil and basophil count in peripheral blood were recorded at baseline and after 4, 12, and 24 weeks. The 22-item Sino-Nasal Outcome Test (S…
Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
AbstractSevere asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS), which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab (OMA) to mepolizumab (MEP) in patients eligible for both biologics, but not optimally controlled by omalizumab. We retrospectively enrolled uncontrolled severe asthmatic patients who switched from OMA to MEP during the last two years. Information included blood eosinophil count, asthma control test (ACT), spirometry, serum IgE, fractional exhaled nitric oxide (FeNO), OCS intake, drugs, exacerbations/hospitalizations, visits and diagno…
Severe asthma: One disease and multiple definitions
Abstract Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED,…
Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis obliterans
Post-infectious bronchiolitis obliterans (PIBO) is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and follo…
Therapeutic effects of benralizumab assessed in patients with severe eosinophilic asthma: Real-life evaluation correlated with allergic and non-allergic phenotype expression
Corrado Pelaia,1 Claudia Crimi,2 Alida Benfante,3 Maria Filomena Caiaffa,4 Cecilia Calabrese,5 Giovanna Elisiana Carpagnano,6 Domenico Ciotta Jnr,7 Maria D’Amato,8 Luigi Macchia,9 Santi Nolasco,2 Girolamo Pelaia,1 Simona Pellegrino,7 Nicola Scichilone,3 Giulia Scioscia,10 Giuseppe Spadaro,11 Giuseppe Valenti,12 Alessandro Vatrella,7 Nunzio Crimi2 1Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy; 2Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; 3Department of Biomedicine and Internal and Specialistic Medicine, University of Palermo, Palermo, Italy; 4Allergology and Clinical Immunol…
Reviewer_1_v.1 – Supplemental material for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy
Supplemental material, Reviewer_1_v.1 for Switching from omalizumab to mepolizumab: real-life experience from Southern Italy by Giovanna Elisiana Carpagnano, Corrado Pelaia, Maria D’Amato, Nunzio Crimi, Nicola Scichilone, Giulia Scioscia, Onofrio Resta, Cecilia Calabrese, Girolamo Pelaia, Carla Maria Irene Quarato and Maria Pia Foschino Barbaro in Therapeutic Advances in Respiratory Disease
Recurrent respiratory infections caused by a double aortic arch: The diagnostic role of spirometry
AbstractA young woman with a clinical history characterized by recurrent respiratory infections, occurring since early infancy, was referred to our hospital. When the patient was a young girl, she underwent sweat chloride test, serum analysis of immunoglobulins, and evaluation of blood lymphocyte subsets; all these diagnostic tests were normal, as well as chest X ray aside from pneumonia episodes. Skin prick tests were positive for several different allergens, and a diagnosis of allergic rhinitis was made. At the age of 11 years, she started to complain of gastroesophageal reflux disease (GERD) symptoms, and a gastroscopy detected a hiatal hernia with esophagitis. Despite pharmacologic trea…
Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life
Abstract Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of workin…