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Mepolizumab Effectiveness and Allergic Status in Real Life.
- Source :
- International Archives of Allergy & Immunology; 2021, Vol. 182 Issue 4, p311-318, 8p
- Publication Year :
- 2021
-
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 FEV<subscript>1</subscript>%, FEF<subscript>25–75</subscript>%, exacerbation numbers, blood eosinophil (BE) counts, fractional exhaled nitric oxide (FENO) (ppb), percentages of patients that stopped/reduced short-acting β2-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 FEV<subscript>1</subscript> >80%, FEF<subscript>25–75</subscript> >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 FEV<subscript>1</subscript>% (β = −0.110; p = 0.266), FEF<subscript>25–75</subscript>% (β = −0.228; p = 0.06), BE counts (β = −0.012; p = 0.918), FENO (β = 0.234; p = 0.085), ACT (β = 0.046; p = 0.660), and exacerbations (β = −0.070; p = 0.437). No different associations between lung function and SNAEA occurrence when compared to SAEA condition (FEV<subscript>1</subscript> >80%: OR = 1.04 [95% CI: 0.43–2.55], p = 0.923; FEF<subscript>25–75</subscript> >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. [ABSTRACT FROM AUTHOR]
- Subjects :
- PHENOTYPES
ASTHMATICS
NITRIC oxide
SEAFARING life
ASTHMA
Subjects
Details
- Language :
- English
- ISSN :
- 10182438
- Volume :
- 182
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- International Archives of Allergy & Immunology
- Publication Type :
- Academic Journal
- Accession number :
- 149589304
- Full Text :
- https://doi.org/10.1159/000511147