Bulut İsmet, Yegin Katran Zeynep, Yavuz Dilek, Yıldız Ali Burkan, Yakut Tuğçe, Örçen Cihan, Mersin Selver Seda
Clinic of Allergy Immunology, Süreyyapaşa Chest Diseases-Thoracic Surgery Training and Research Hospital, University of Health Sciences İstanbul, Türkiye.
Clinic of Allergy Immunology, Diyarbakır Training and Research Hospital, Diyarbakır, Türkiye.
Tuberk Toraks. 2023 Jun;71(2):148-155. doi: 10.5578/tt.20239918.
Effectiveness of mepolizumab in patients with severe eosinophilic asthma: In a real life study
We analyzed the effects of mepolizumab treatment on symptoms, asthma attacks, pulmonary function test parameters peripheral blood eosinophil level, and percentage in patients with severe eosinophilic asthma receiving mepolizumab treatment as the baseline, sixth and twelfthmonth data.
The medical records of patients diagnosed with severe eosinophilic asthma and treated with mepolizumab at our clinic were retrospectively reviewed for the period between January 2018 and December 2021. Demographic data of the patients, duration of asthma disease, comorbidities such as a nasal polyp, eosinophilic granulomatous polyangiitis, and nonsteroidal anti-inflammatory drug exacerbated respiratory disease were investigated. A comparison was made of various factors before initiating mepolizumab treatment, as well as at the sixth and twelfth month after treatment initiation. These factors include asthma control test scores, frequency of asthma attacks (including emergency admissions, hospitalizations, and intensive care admissions), peripheral blood eosinophil levels and percentages, and pulmonary function test parameters. Clinic and laboratory parameters that provide a prediction of being a responder and super responder were evaluated.
A total of 21 patients were included in the study. Their mean age was 50.7 ± 11.9 years, and four (19%) were males. The mean duration of asthma diagnosis was 17.5 ±13.7 years. 14 patients (66.7%) were atopic. 4 patients (19%) had nasal polyps and four patients (19%) had NERD. Before mepolizumab, 13 (61.9%) patients had received omalizumab. The duration of receiving mepolizumab treatment was 29.2 ± 9.9 months. A statistically significant dec rease was observed in both the number and percentage of eosinophils at months six and 12 (p< 0.01). There was a statistically significant increase in FEV values both as a percentage and in milliliters at month 12. There was an increase in both percentage and milliliters in FEF values, but this increase did not reach statistical significance. There was a decrease in service admissions, intensive care admissions, and emergency admissions due to asthma exacerbations. Out of 21 patients, 11 (52.4%) were classified as responders, while 10 (47.6%) were classified as super responders.
Although the number of patients in our study was limited, mepolizumab improved symptom scores in severe eosinophilic asthma, reduced the number of attacks, and improved pulmonary function test values.
美泊利珠单抗治疗重度嗜酸性粒细胞性哮喘患者的有效性：一项真实世界研究
我们分析了以美泊利珠单抗治疗重度嗜酸性粒细胞性哮喘患者时，治疗对症状、哮喘发作、肺功能测试参数、外周血嗜酸性粒细胞水平及百分比的影响，数据以基线、第6个月和第12个月为准。
回顾性分析2018年1月至2021年12月期间在我们诊所被诊断为重度嗜酸性粒细胞性哮喘并接受美泊利珠单抗治疗的患者的病历。调查患者的人口统计学数据、哮喘病程、合并症，如鼻息肉、嗜酸性肉芽肿性多血管炎和非甾体抗炎药加重的呼吸道疾病。对开始美泊利珠单抗治疗前以及治疗开始后第6个月和第12个月的各种因素进行比较。这些因素包括哮喘控制测试评分、哮喘发作频率（包括急诊入院、住院和重症监护入院）、外周血嗜酸性粒细胞水平和百分比以及肺功能测试参数。评估了能够预测患者是否为反应者和超级反应者的临床和实验室参数。
共有21例患者纳入研究。他们的平均年龄为50.7±11.9岁，4例（19%）为男性。哮喘诊断的平均病程为17.5±13.7年。14例患者（66.7%）为特应性体质。4例患者（19%）有鼻息肉，4例患者（19%）有NERD。在使用美泊利珠单抗之前，13例（61.9%）患者接受过奥马珠单抗治疗。接受美泊利珠单抗治疗的时长为29.2±9.9个月。在第6个月和第12个月时，嗜酸性粒细胞的数量和百分比均出现了具有统计学意义的下降（p<0.01）。在第12个月时，FEV值无论是以百分比还是以毫升为单位均出现了具有统计学意义的升高。FEF值在百分比和毫升数方面均有所增加，但这种增加未达到统计学意义。因哮喘加重导致的门诊入院、重症监护入院和急诊入院次数均有所减少。在21例患者中，11例（52.4%）被归类为反应者，而10例（47.6%）被归类为超级反应者。
尽管我们研究中的患者数量有限，但美泊利珠单抗改善了重度嗜酸性粒细胞性哮喘的症状评分，减少了发作次数，并改善了肺功能测试值。
