Benralizumab as a Steroid-Sparing Treatment Option in Eosinophilic Granulomatosis with Polyangiitis
| Autor: | Mary Gill, Yeshai T. Dollin, Vamsi P. Guntur, Joshua L. Denson, Christena A. Kolakowski, Michael E. Wechsler, Laurie A. Manka, Ryan M. Dunn, Matthew Strand |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Exacerbation medicine.drug_class Pilot Projects Churg-Strauss Syndrome Antibodies Monoclonal Humanized Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Immunology and Allergy Medicine Humans 030212 general & internal medicine Dosing Prospective Studies Adverse effect Anti-neutrophil cytoplasmic antibody business.industry Granulomatosis with Polyangiitis Benralizumab medicine.disease 030228 respiratory system chemistry Corticosteroid Steroids business Granulomatosis with polyangiitis Mepolizumab medicine.drug |
| Zdroj: | The journal of allergy and clinical immunology. In practice. 9(3) |
| ISSN: | 2213-2201 |
| Popis: | Background Eosinophilic granulomatosis with polyangiitis (EGPA) is a vasculitis associated with significant morbidity and mortality that has historically been treated with systemic corticosteroids and immunosuppressants. The IL-5 antagonist mepolizumab was Food and Drug Administration approved in 2017 after demonstrating safety and efficacy in EGPA. We hypothesized that benralizumab, an IL-5 receptor antagonist approved for eosinophilic asthma, would demonstrate safety and efficacy in EGPA. Objectives To determine the safety and efficacy of benralizumab in EGPA as measured by reduction in oral corticosteroid dose and EGPA exacerbations. Methods We conducted a prospective 40-week open-label pilot study of benralizumab 30 mg administered subcutaneously in 10 patients with EGPA. Adverse events, oral corticosteroid dosing, exacerbations, and lung function were evaluated before, during, and after benralizumab treatment. Paired tests and tests derived from longitudinal models were used to compare outcome variables between phases or visits. Results Benralizumab was well tolerated and resulted in reduction of median corticosteroid dose from 15 mg at the start to 2 mg at the end of treatment. Geometric mean corticosteroid dose was reduced from 11.6 mg during pretreatment to 6.3 mg during treatment phase. Five patients were able to achieve a dose of 0 mg. Mean annualized exacerbation rate was lowest during the treatment (1.5) compared with the pre- and posttreatment phases (4.6, P = .008 for treatment vs pre- and postphases combined). Conclusions Benralizumab was well tolerated, facilitated oral corticosteroid reduction, and reduced exacerbations in EGPA. Larger controlled trials are warranted to further evaluate the role of benralizumab in EGPA. |
| Databáze: | OpenAIRE |
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