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美泊利珠单抗治疗一年的疗效和安全性:意大利真实世界研究。

One year of mepolizumab. Efficacy and safety in real-life in Italy.

机构信息

Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Italy.

Asthma Center and Allergy Unit, Verona University and General Hospital, Department of Medicine, University of Verona, Verona, Italy.

出版信息

Pulm Pharmacol Ther. 2019 Oct;58:101836. doi: 10.1016/j.pupt.2019.101836. Epub 2019 Aug 29.

Abstract

BACKGROUND

Severe asthma is a disease with a heavy socio-economic burden and a relevant impact on the life of patients. Mepolizumab (MEP) was recently introduced in practice. The previous data were favourable as efficacy and safety are concerned. Nowadays, we can report the clinical data after more than one year of use of MEP in the real-life setting.

OBJECTIVE

To evaluate the efficacy and safety of MEP in a real life framework, mainly concerning asthma exacerbations, steroid dependence, effects on respiratory function and adverse events.

METHODS

This retrospective analysis was performed on 138 patients, treated with MEP for at least 12 months, and referred to eleven severe asthma clinics in Italy. All patients met the criteria for severe uncontrolled asthma according to ATS/ERS guidelines and prescribing MEP conditions according to the Italian Drug Agency (AIFA).

RESULTS

We could observe 138 patients (78 female, age 58 ± 10 years). The average age of onset of asthma was 34 ± 16 years. The blood eosinophil count decreased from 822 ± 491/μL at baseline to 117 ± 96/μL (p < .0001) after 12 months of therapy. Exacerbations decreased from 3.8/year to 0.7/year (-81%; p < .0001). Steroid-dependent patients before MEP (80%) with a daily dose of 10.1 ± 9.4 mg prednisone decrease at 28% after 12 months with a mean of 2.0 ± 4.2 mg/day (p < .0001). The occurrence of adverse events was overall low.

CONCLUSIONS & CLINICAL RELEVANCE: In this real-life setting, MEP confirmed its efficacy and safety profile, already shown in clinical trials. This was apparent concerning exacerbation rate, systemic steroids intake and safety.

摘要

背景

重度哮喘是一种具有沉重社会经济负担且对患者生活有重大影响的疾病。美泊利珠单抗(MEP)最近已在临床应用。既往数据显示其具有疗效和安全性。目前,我们可以报告在真实环境中使用 MEP 超过一年后的临床数据。

目的

评估 MEP 在真实环境中的疗效和安全性,主要关注哮喘加重、激素依赖、对呼吸功能的影响和不良反应。

方法

对意大利 11 家重度哮喘诊所的 138 名至少接受 12 个月 MEP 治疗的患者进行了这项回顾性分析。所有患者均根据 ATS/ERS 指南符合重度未控制哮喘标准,且根据意大利药品管理局(AIFA)规定符合 MEP 治疗条件。

结果

我们观察到 138 名患者(78 名女性,年龄 58±10 岁)。哮喘的平均发病年龄为 34±16 岁。治疗 12 个月后,外周血嗜酸性粒细胞计数从基线时的 822±491/μL 降至 117±96/μL(p<0.0001)。哮喘加重从 3.8/年减少至 0.7/年(-81%;p<0.0001)。治疗前依赖激素(80%)的患者每日泼尼松剂量为 10.1±9.4mg,12 个月后降至 28%,平均剂量为 2.0±4.2mg/天(p<0.0001)。不良反应的总体发生率较低。

结论和临床相关性

在真实环境中,MEP 证实了其已在临床试验中显示出的疗效和安全性。这在哮喘加重率、全身激素摄入和安全性方面表现明显。

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