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Safety and effectiveness of mepolizumab therapy in remission induction therapy for eosinophilic granulomatosis with polyangiitis: a retrospective study
Arthritis Research & Therapy ( IF 4.9 ) Pub Date : 2022-06-29 , DOI: 10.1186/s13075-022-02845-3
Masanobu Ueno 1 , Ippei Miyagawa 1 , Takafumi Aritomi 1 , Koichi Kimura 1 , Shigeru Iwata 1 , Kentaro Hanami 1 , Syunsuke Fukuyo 1 , Satoshi Kubo 1 , Yusuke Miyazaki 1 , Shingo Nakayamada 1 , Yoshiya Tanaka 1
Affiliation  

To investigate the safety and effectiveness of mepolizumab (MPZ), an anti-interleukin-5 antibody, as remission induction therapy for severe eosinophilic granulomatosis with polyangiitis (EGPA). The clinical courses of patients with severe EGPA over 6 months were retrospectively investigated and compared between patients treated with high-dose corticosteroid (CS) plus MPZ therapy (MPZ group, n = 7) and those treated with high-dose CS plus intravenous cyclophosphamide (IVCY) pulse therapy (IVCY group, n = 13). The primary endpoints were the MPZ retention rate and the IVCY completion rate. The secondary endpoints were adverse events and changes in the Birmingham Vasculitis Activity Score (BVAS), Vascular Damage Index (VDI), eosinophil counts, and concomitant CS doses, and the extent and rates of these changes were compared between the MPZ and IVCY groups. Regarding the primary endpoints, the MPZ retention rate was 100%, and the IVCY completion rate was 61.5%. Regarding the secondary endpoints, adverse events were detected in 2/7 patients (28.6%) in the MPZ group and 7/13 patients (53.8%) in the IVCY group. BVAS and eosinophil counts significantly decreased in both groups at and after month 1, but there was no significant difference in the magnitude of changes between the two groups. VDI scores did not significantly increase in either group, and the degree of changes did not significantly differ between the two groups. Although concomitant CS doses significantly decreased at and after month 1 in both groups, the rates of decrease in CS doses at and after month 3 were significantly higher in the MPZ group. This study suggested that the use of MPZ as remission induction therapy for severe EGPA might be safe and effective for controlling disease activity and reducing CS doses.

中文翻译:

美泊利单抗治疗嗜酸性肉芽肿伴多血管炎缓解诱导治疗的安全性和有效性:一项回顾性研究

研究美泊利单抗 (MPZ)(一种抗白细胞介素 5 抗体)作为重度嗜酸性肉芽肿伴多血管炎 (EGPA) 缓解诱导治疗的安全性和有效性。回顾性研究了重度 EGPA 患者 6 个月以上的临床病程,比较了大剂量糖皮质激素(CS)加 MPZ 治疗(MPZ 组,n = 7)与大剂量 CS 加静脉环磷酰胺治疗的患者。 IVCY) 脉冲治疗(IVCY 组,n = 13)。主要终点是 MPZ 保留率和 IVCY 完成率。次要终点是伯明翰血管炎活动评分 (BVAS)、血管损伤指数 (VDI)、嗜酸性粒细胞计数和伴随 CS 剂量的不良事件和变化,并在 MPZ 和 IVCY 组之间比较了这些变化的程度和发生率。关于主要终点,MPZ 保留率为 100%,IVCY 完成率为 61.5%。关于次要终点,MPZ 组 2/7 名患者 (28.6%) 和 IVCY 组 7/13 名患者 (53.8%) 检测到不良事件。BVAS 和嗜酸性粒细胞计数在第 1 个月和之后两组均显着下降,但两组之间的变化幅度没有显着差异。两组的 VDI 评分均没有显着增加,并且两组之间的变化程度没有显着差异。尽管两组中伴随的 CS 剂量在第 1 个月和之后显着减少,但 MPZ 组在第 3 个月和之后的 CS 剂量减少率显着更高。
更新日期:2022-06-29
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