6533b7d5fe1ef96bd126527c
RESEARCH PRODUCT
Mepolizumab effectiveness on small airway obstruction, corticosteroid sparing and maintenance therapy step-down in real life
Gianna CamiciottoliCorrado PelaiaPierluigi PaggiaroIlenia FollettiPierachille SantusElena BargagliBruno SposatoMauro ManiscalcoManuela LatorreSimonetta MasieriAmelia GrossoGirolamo PelaiaGiulio BardiAntonino MusarraAlberto RicciAngelo CorsicoMarco ScalesePaolo CameliNicola ScichiloneGiovanna Elisiana CarpagnanoElena BacciPaola RoglianiNicola MurgiaStefano Baglionisubject
MaleOmalizumabFEF(25-75)step-down0302 clinical medicineMaintenance therapyAdrenal Cortex HormonesSettore MED/10Pharmacology (medical)Anti-Asthmatic Agents030212 general & internal medicinesmall airwaysAsthma exacerbationsmepolizumabMiddle AgedAnesthesiaFEF25-75CorticosteroidDrug Therapy CombinationFemalemedicine.drugPulmonary and Respiratory Medicinesevere asthmamedicine.drug_classMepolizumab Severe asthma Real-life Small airways FEF25-75 Oral corticosteroids Step-down EffectiveneseffectivenessSettore MED/10 - Malattie Dell'Apparato Respiratoriooral corticosteroidsAntibodies Monoclonal HumanizedNO03 medical and health sciencesEffectiveness FEF 25-75 Mepolizumab Oral corticosteroids Real-life Severe asthma Small airways Step-downmedicineHumansIn real lifeFEFreal-lifeAgedRetrospective StudiesBiologic markerbusiness.industryEffectivenesBiochemistry (medical)Effectiveness; FEF; 25-75; Mepolizumab; Oral corticosteroids; Real-life; Severe asthma; Small airways; Step-downAirway obstructionmedicine.diseaseAsthmaBlood Cell Countrespiratory tract diseasesAirway ObstructionEosinophils030228 respiratory systemeffectiveness; FEF(25-75); mepolizumab; oral corticosteroids; real-life; severe asthma; small airways; step-down25-75businessMepolizumabdescription
Background: Mepolizumab (MEP) has been recently introduced to treat severe eosinophilic asthma. Trials have demonstrated a significant effectiveness in this asthma phenotype. We evaluated MEP efficacy on lung function, symptoms, asthma exacerbations, biologic markers, steroid dependence and controller treatment level in real-life. Methods: We retrospectively analyzed 134 severe asthmatics (61 males; mean age 58.3 ± 11; mean FEV1%:72 ± 21), treated with MEP for at least 6 months (mean duration:10.9 ± 3.7 months). Results: FEV1% improved significantly after MEP. Mean FEF25-75 also increased from 37.4 ± 25.4% to 47.2 ± 27.2% (p < 0.0001). Mean baseline blood eosinophil level was 712 ± 731/μL (8.4 ± 5.2%) decreasing to 151 ± 384/μL (1.6 ± 1.6%) (p < 0.0001), FENO levels decreased likewise. MEP treatment also led to a significant ACT improvement (mean pre:14.2 ± 4.4; mean post:20.5 ± 28) and exacerbations significantly fell from 3.8 ± 1.9 to 0.8 ± 1.1 (p < 0.0001). 74% of patients were steroid-dependent before MEP. 45.4% and 46.4% of them showed a suspension and dose reduction respectively (p < 0.0001). A significant number reduced also ICS doses. Only 67% of subjects used SABA as needed before MEP, falling to 20% after MEP. About 40% of patients highlighted a maintenance therapy step-down. Subjects showing an omalizumab treatment failure before MEP had a similar positive response when compared with omalizumab untreated patients. Conclusion: In real-life, MEP improved significantly all outcomes even small airway obstruction, suggesting its possible role also in distal lung region treatment. Furthermore, it demonstrated its high effectiveness in OC/ICS-sparing, in reducing SABA as needed and in stepping-down maintenance therapy. MEP is a valid alternative for patients with previous omalizumab treatment failure.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |