Benralizumab for eosinophilic granulomatosis with polyangiitis.

Autor:	Cottu A; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France., Groh M; National Referral Center for Hypereosinophilic Syndrome (CEREO), Department of Internal Medicine, Hopital Foch, Suresnes, France., Desaintjean C; Department of Respiratory Diseases, Hospital for Cardiologie and Pneumology Louis Pradel, Lyon, France., Marchand-Adam S; Service de pneumologie et d'explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France., Guillevin L; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France., Puechal X; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France., Beaumesnil S; Department of Internal Medicine and Infectious Diseases, University Hospital Centre, Bordeaux, France., Lazaro E; Department of Internal Medicine and Infectious Diseases, University Hospital Centre, Bordeaux, France., Samson M; Department of Internal Medicine and Clinical Immunology, University Hospital Centre, Dijon, France., Taille C; Reference Center for Rare Pulmonary Diseases and University of Paris Cité, Inserm 1152, Hospital Bichat - Claude-Bernard, Paris, France., Durel CA; Department of Internal Medicine, Edouard Herriot Hospital, Lyon, France., Diot E; Department of Internal Medicine, CHRU de Tours, Tours, France., Nicolas S; Department of Internal Medicine, CHRU de Tours, Tours, France., Guilleminault L; Department of Respiratory Medicine, University Hospital Centre Toulouse, Toulouse, France.; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Inserm U1291, CNRS U5282, Toulouse 2 University, Toulouse, France., Ebbo M; Departement of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, Marseille, France., Cathebras P; Department of Internal Medicine, CHU, Saint-Etienne, France., Dupin C; Reference Center for Rare Pulmonary Diseases and University of Paris Cité, Hospital Bichat - Claude-Bernard, Paris, France., Yildiz H; Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Bruxelles, Belgium., Belfeki N; Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Sud Ile-de-France, Melun, France., Pugnet G; Department of Internal Medicine and Clinical Immunology, CHU Toulouse Rangueil, Toulouse, France., Chauvin P; Department of Respiratory Diseases, University Hospital Centre Rennes, Rennes, France., Jouneau S; Department of Respiratory Diseases, IRSET UMR 1085, Rennes 1 University, Pontchaillou Hospital, Rennes, France., Lifermann F; Department of Internal Medicine, Centre Hospitalier de Dax, Dax, France., Martellosio JP; Department of Internal Medicine, Centre Hospitalier Universitaire de Poitiers, Poitiers, France., Cottin V; Department of Respiratory Diseases, Hospital for Cardiologie and Pneumology Louis Pradel, Lyon, France., Terrier B; Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France benjamin.terrier@aphp.fr.; Université Paris Cité, Paris, France.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2023 Dec; Vol. 82 (12), pp. 1580-1586. Date of Electronic Publication: 2023 Aug 07.
DOI:	10.1136/ard-2023-224624
Abstrakt:	Background: Benralizumab is effective in the treatment of eosinophilic asthma and is being investigated for the treatment of other eosinophil-associated diseases. Reports on the use of benralizumab for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) are limited to case reports and small case series. Methods: We conducted a multicentre, retrospective study including EGPA patients treated with off-label benralizumab. The primary endpoint was the rate of complete response defined as no disease activity (Birmingham Vasculitis Activity Score=0) and a prednisone dose ≤4 mg/day. Partial response was defined as no disease activity and a prednisone dose ≥4 mg/day. Results: Sixty-eight patients were included, including 31 (46%) who had previously received mepolizumab. The use of benralizumab was warranted by uncontrolled asthma in 54 (81%), persistent ear, nose and throat (ENT) manifestations in 27 (40%) and persistent glucocorticoids (GCs) use in 48 (74%) patients. Median (IQR) follow-up after starting benralizumab was 23 (9-34) months. Thirty-three patients (49%) achieved a complete response, 24 (36%) achieved a partial response and 10 (15%) did not respond. Among the 57 patients who initially responded, 10 (18%) eventually required further line treatments. GCs were discontinued in 23 patients (38%). Prior mepolizumab use was associated with a higher rate of primary failure (26.7% vs 5.4%, p=0.034) and less frequent GCs discontinuation (14.8% vs 55.9%, p=0.001). Vasculitis flares occurred in 7 patients (11%) and were associated with histological evidence of vasculitis and/or antineutrophil cytoplasmic antibodies positivity at benralizumab initiation (p=0.004). Conclusions: Benralizumab appears to be an effective treatment for refractory asthma or ENT manifestations in EGPA and allows GC-sparing. However, its efficacy was lower after prior failure of mepolizumab. Competing Interests: Competing interests: The authors declare no financial support. MG reports personal fees from GlaxoSmithKline and AstraZeneca outside the submitted work. CT reports personal fees from AstraZeneca, Sanofi, GlaxoSmithKline, Chiesi and Novartis outside the submitted work. CDupin reports personal fees from AstraZeneca and GlaxoSmithKline outside the submitted work. HY reports personal fees from GlaxoSmithKline outside the submitted work. Other authors has nothing to disclose. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu