Hwee Jeremiah, Huynh Lynn, da Costa Wilson, Rothenberg Marc E, Duh Mei Sheng, Alfonso-Cristancho Rafael
Epidemiology, GSK, Mississauga, ON, Canada.
Analysis Group, Inc., Boston, MA, United States.
Front Allergy. 2025 May 23;6:1605397. doi: 10.3389/falgy.2025.1605397. eCollection 2025.
Limited data exist on the burden of myeloproliferative, lymphocytic and idiopathic subtypes of hypereosinophilic syndrome (M-HES, L-HES and I-HES) and the characteristics of patients with HES receiving biologic therapies. This analysis aimed to further characterize these subtypes and explore the impact of biologics in a real-world European setting.
This was a subgroup analysis of a retrospective, non-interventional, chart review (GSK ID: 214657) across five European countries. Index date was first clinical visit during January 2015-December 2019 (after or at time of HES diagnosis). Patients with HES aged ≥6 years with ≥1-year follow-up from index were included. Demographics, disease characteristics, diagnostic assessments, comorbidities, types of treatment, clinical manifestations, clinical outcomes and HES-related healthcare resource utilization were summarized for HES overall and subtypes. Oral corticosteroid (OCS) use and clinical manifestations/outcomes were assessed 12-months pre- and post-biologics.
The analysis included 280 patients with I-HES ( = 155), M-HES ( = 66), L-HES ( = 42) and chronic eosinophilic leukemia ( = 2). The most common clinical manifestations were fatigue (54.2% I-HES, 52.4% L-HES, 42.4% M-HES), skin itch (36.4% M-HES, 35.7% L-HES, 33.5% I-HES) and pain (31.0% L-HES, 30.3% M-HES, 27.1% I-HES). Biologic use was highest with L-HES (64.3%), followed by I-HES (43.9%) and M-HES (34.8%). Clinical response rates were highest for the I-HES subtype (75.5%; 66.7% L-HES, 63.6% M-HES). Hospitalizations were highest for L-HES (45.2%; 30.3% M-HES, 25.8% I-HES). The annualized rate of OCS prescriptions reduced by 56.8% (0.44-0.19 per person-year) and the proportion of patients with ≥1 clinical response increased 3.6-fold (6.5%-23.4%) between the pre- and post-biologics periods.
All HES subtypes had a substantial disease burden and were commonly associated with fatigue, skin itch and pain. I-HES appeared to be more responsive to treatment than L-HES and M-HES. Biologic use for HES led to more patients experiencing clinical responses and was OCS-sparing.
关于嗜酸性粒细胞增多综合征的骨髓增殖性、淋巴细胞性和特发性亚型（M-HES、L-HES和I-HES）的负担以及接受生物疗法的嗜酸性粒细胞增多综合征患者的特征，现有数据有限。本分析旨在进一步描述这些亚型，并探讨生物制剂在欧洲实际环境中的影响。
这是一项对五个欧洲国家进行的回顾性、非干预性病历审查（GSK ID：214657）的亚组分析。索引日期为2015年1月至2019年12月期间的首次临床就诊（嗜酸性粒细胞增多综合征诊断之后或之时）。纳入年龄≥6岁、自索引日期起有≥1年随访的嗜酸性粒细胞增多综合征患者。总结了嗜酸性粒细胞增多综合征总体及其亚型的人口统计学、疾病特征、诊断评估、合并症、治疗类型、临床表现、临床结局以及与嗜酸性粒细胞增多综合征相关的医疗资源利用情况。在生物制剂治疗前和治疗后12个月评估口服糖皮质激素（OCS）的使用情况以及临床表现/结局。
分析纳入了280例I-HES患者（n = 155）、M-HES患者（n = 66）、L-HES患者（n = 42）和慢性嗜酸性粒细胞白血病患者（n = 2）。最常见的临床表现为疲劳（I-HES患者中占54.2%，L-HES患者中占52.4%，M-HES患者中占42.4%）、皮肤瘙痒（M-HES患者中占36.4%，L-HES患者中占35.7%，I-HES患者中占33.5%）和疼痛（L-HES患者中占31.0%，M-HES患者中占30.3%，I-HES患者中占27.1%）。L-HES患者生物制剂的使用率最高（64.3%），其次是I-HES患者（43.9%）和M-HES患者（34.8%）。I-HES亚型的临床缓解率最高（75.5%；L-HES患者为66.7%，M-HES患者为63.6%）。L-HES患者的住院率最高（45.2%；M-HES患者为30.3%，I-HES患者为25.8%）。在生物制剂治疗前和治疗后期间，OCS处方的年化率降低了56.8%（从每人每年0.44降至0.19），有≥1次临床缓解的患者比例增加了3.6倍（从6.5%增至23.4%）。
所有嗜酸性粒细胞增多综合征亚型都有相当大 的疾病负担，并且通常与疲劳、皮肤瘙痒和疼痛相关。I-HES似乎比L-HES和M-HES对治疗更敏感。嗜酸性粒细胞增多综合征使用生物制剂使更多患者出现临床缓解，并且减少了OCS的使用。
