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MPO-ANCA-positive eosinophilic granulomatosis with polyangiitis complicated by alveolar hemorrhage treated with mepolizumab as an induction therapy: Case report.
Mod Rheumatol Case Rep
December 2024
Department of Rheumatology and Clinical Immunology, Wakayama Medical University, Wakayama, Japan.
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis preceded by bronchial asthma or allergic sinusitis and accompanied by peripheral blood eosinophilia. Immunosuppressive drugs, such as cyclophosphamide in addition to high-dose glucocorticoids, are recommended for induction of remission in patients with severe EGPA. Although mepolizumab is widely recognized as remission induction therapy in non-fatal/non-organ disabling or relapsed/refractory EGPA, its efficacy and safety in induction of remission for severe cases have been ambiguous.
View Article and Find Full Text PDFThe clinical question of mepolizumab in the long-term treatment of idiopathic chronic eosinophilic pneumonia; how long should we use mepolizumab?
Respir Med Case Rep
November 2024
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan.
The efficacy of mepolizumab as an alternative to glucocorticoids for treating idiopathic chronic eosinophilic pneumonia (ICEP) has been reported. However, various questions remain unanswered, such as the most appropriate dose and dosage interval of mepolizumab for ICEP, how long efficacy is maintained, how long administration should be continued, and whether and when discontinuation can be considered. We present herein three cases of refractory ICEP treated with mepolizumab at a dose of 100 mg every 4 or 8 weeks.
View Article and Find Full Text PDFReal-world safety and effectiveness of mepolizumab for patients with eosinophilic granulomatosis with polyangiitis in Japan: long-term observation of the MARS study.
Mod Rheumatol
November 2024
Global Medical Affairs, GSK, London, UK.
Article Synopsis
- The MARS study aimed to collect long-term safety and effectiveness data for mepolizumab treatment in patients with eosinophilic granulomatosis with polyangiitis in Japan.
- In the study, conducted over 192 weeks, about 58% of patients experienced adverse events, but none were linked directly to mepolizumab. There were notable improvements in patient symptoms and a decrease in the need for oral glucocorticoids.
- The findings support that mepolizumab is well tolerated and effective for managing this condition, demonstrating an increase in symptom-free patients and decreased steroid dependency.
Long-term efficacy of mepolizumab in patients with eosinophilic granulomatosis with polyangiitis: a propensity score matching analysis in the multicenter REVEAL cohort study.
Front Immunol
October 2024
Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Background: Mepolizumab (MPZ) has demonstrated efficacy in clinical trials for eosinophilic granulomatosis with polyangiitis (EGPA); however, few studies compare the disease course between patients treated with MPZ (MPZ group) and those who were not treated with MPZ (non-MPZ group) in real-world settings.
Objectives: This study aimed to compare the disease course and outcomes between the two groups and assess the long-term efficacy of MPZ in a multicenter cohort in Japan. Methods: We enrolled 113 EGPA patients registered in the cohort until June 2023.
Targeted inhibition of the IL5 axis for immune checkpoint inhibitors eosinophilic-induced adverse events.
J Immunother Cancer
October 2024
Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah University Medical Center Division of Internal Medicine, Jerusalem, Israel.
Article Synopsis
- Immune checkpoint inhibitors (ICI) for cancer like pembrolizumab and nivolumab can lead to immune-related adverse events (Eo-irAE), including high eosinophil levels that may predict positive treatment responses but can also cause significant organ dysfunction.
- This study evaluates the use of interleukin (IL) 5-axis inhibition to treat Eo-irAE, using medications like mepolizumab and benralizumab in three patients who developed these adverse effects after ICI therapy.
- Results showed rapid improvement in symptoms and a reduction in eosinophil levels with no negative impacts from the IL-5 targeted treatments, indicating they can be effective in managing Eo-irAE in cancer patients undergoing ICI
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