Mepolizumab Reduces Hypereosinophilic Syndrome Flares Irrespective of Blood Eosinophil Count and Interleukin-5.
J Allergy Clin Immunol Pract
; 10(9): 2367-2374.e3, 2022 09.
Article
en En
| MEDLINE
| ID: mdl-35568330
ABSTRACT
BACKGROUND:
Mepolizumab, an anti-interleukin-5 (IL-5) antibody, reduces disease flares in patients with hypereosinophilic syndrome (HES). Factors predicting treatment response are unknown.OBJECTIVE:
To assess mepolizumab efficacy by baseline blood eosinophil count (BEC) and serum IL-5 level in patients with HES.METHODS:
This post hoc analysis used data from the phase III study assessing mepolizumab in patients with HES (NCT02836496). Patients 12 years old or older, with HES for 6 or more months, 2 or more flares in the previous year, and BEC ≥1,000 cells/µL at screening were randomized (11) to 4-weekly subcutaneous mepolizumab (300 mg) or placebo, plus baseline HES therapy, for 32 weeks. The proportion of patients experiencing 1 or more flares (wk 32), annualized flare rate, and proportion of patients with change from baseline in Brief Fatigue Inventory (BFI) item 3 (wk 32), were analyzed by baseline BEC (<1500/≥1500 to <2500/≥2500 cells/µL). Flare outcomes were assessed by baseline serum IL-5 (<7.81/≥7.81 pg/mL).RESULTS:
Across baseline BEC subgroups, mepolizumab reduced the proportion of patients experiencing 1 or more flares by 63% to 90% and flare rate by 58% to 84% (treatment-by-eosinophil interaction P = .76 and P = .90, respectively); patients had improved BFI item 3 score with mepolizumab versus placebo (cells/µL <1,500 54% vs 37%; ≥1,500 to <2,500 47% vs 31%; ≥2,500 61% vs 0%; treatment-by-eosinophil interaction P = .42). Most patients had undetectable baseline serum IL-5 levels; among these, mepolizumab versus placebo reduced the proportion of patients with 1 or more flares (77%) and flare rate (67%).CONCLUSIONS:
Mepolizumab was efficacious in the patients with HES studied, irrespective of baseline BEC. Undetectable IL-5 levels should not preclude mepolizumab treatment.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Interleucina-5
/
Síndrome Hipereosinofílico
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Allergy Clin Immunol Pract
Año:
2022
Tipo del documento:
Article