Mepolizumab Effectiveness and Allergic Status in Real Life.
Int Arch Allergy Immunol
; 182(4): 311-318, 2021.
Article
em En
| MEDLINE
| ID: mdl-33113532
ABSTRACT
BACKGROUND:
It is not clear whether mepolizumab is differently effective in allergic and nonallergic severe eosinophilic asthmatics (SEA) in real life.OBJECTIVE:
We tested mepolizumab effectiveness in allergic/nonallergic SEA in real life. A strict criterion to identify the 2 phenotypes was used.METHOD:
We retrospectively considered 134 consecutive patients divided into allergic, with a positivity to at least 1 allergen to prick tests and/or IgE values ≥100 UI/mL (severe allergic eosinophilic asthma [SAEA]; n 97-72.4%), and nonallergic, with no prick test results and normal IgE levels <100 UI/mL (severe nonallergic eosinophilic asthma [SNAEA]; n 37-27.6%). They had taken mepolizumab for at least 6 months.RESULTS:
After 10.9 ± 3.7 months, improvements in FEV1%, FEF25-75%, exacerbation numbers, blood eosinophil (BE) counts, fractional exhaled nitric oxide (FENO) (ppb), percentages of patients that stopped/reduced short-acting ß2-agonists (SABAs) or oral corticosteroid (OC), observed after treatment, were similar in both groups. Only Asthma Control Test (ACT) increases were higher in SNAEA (8 [5-9]) than in SAEA (5 [2.5-8.5]; p = 0.016). However, no differences were found after treatment in percentages of subjects with ACT ≥20, as well as with FEV1 >80%, FEF25-75 >65%, exacerbations ≤2, BE <300 cells/µL, and FENO <25 ppb between SAEA and SNAEA. Besides, no significant relationships were found, comparing SNAEA with SAEA, for FEV1% (ß = -0.110; p = 0.266), FEF25-75% (ß = -0.228; p = 0.06), BE counts (ß = -0.012; p = 0.918), FENO (ß = 0.234; p = 0.085), ACT (ß = 0.046; p = 0.660), and exacerbations (ß = -0.070; p = 0.437). No different associations between lung function and SNAEA occurrence when compared to SAEA condition (FEV1 >80% OR = 1.04 [95% CI 0.43-2.55], p = 0.923; FEF25-75 >65% OR = 0.41 [95% CI 0.08-2.03], p = 0.272) were detected. Neither all other parameters, such as ACT >20 (OR = 0.73 [95% CI 0.32-1.63], p = 0.440), presence of exacerbations (OR = 1.35 [95% CI 0.55-3.27], p = 0.512), SABA discontinuation (OR = 1.16 [95% CI 0.40-3.39], p = 0.790), and OC cessation/reduction (OR = 3.44 [95% CI 0.40-29.27], p = 0.258), were differently associated with 1 or the other phenotype.CONCLUSION:
Mepolizumab can be considered as a valid therapeutic choice for either allergic or nonallergic SEA in real life.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Antialérgicos
/
Anticorpos Monoclonais Humanizados
/
Hipersensibilidade
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Int Arch Allergy Immunol
Assunto da revista:
ALERGIA E IMUNOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article