Mepolizumab for Eosinophilic Granulomatosis With Polyangiitis: A European Multicenter Observational Study. Issue 2 (30th December 2021)

• Record Type: Journal Article
• Authors: Bettiol, Alessandra; Urban, Maria Letizia; Dagna, Lorenzo; Cottin, Vincent; Franceschini, Franco; Del Giacco, Stefano; Schiavon, Franco; Neumann, Thomas; Lopalco, Giuseppe; Novikov, Pavel; Baldini, Chiara; Lombardi, Carlo; Berti, Alvise; Alberici, Federico; Folci, Marco; Negrini, Simone; Sinico, Renato Alberto; Quartuccio, Luca; Lunardi, Claudio; Parronchi, Paola; Moosig, Frank; Espígol‐Frigolé, Georgina; Schroeder, Jan; Kernder, Anna Luise; Monti, Sara; Silvagni, Ettore; Crimi, Claudia; Cinetto, Francesco; Fraticelli, Paolo; Roccatello, Dario; Vacca, Angelo; Mohammad, Aladdin J.; Hellmich, Bernhard; Samson, Maxime; Bargagli, Elena; Cohen Tervaert, Jan Willem; Ribi, Camillo; Fiori, Davide; Bello, Federica; Fagni, Filippo; Moroni, Luca; Ramirez, Giuseppe Alvise; Nasser, Mouhamad; Marvisi, Chiara; Toniati, Paola; Firinu, Davide; Padoan, Roberto; Egan, Allyson; Seeliger, Benjamin; Iannone, Florenzo; Salvarani, Carlo; Jayne, David; Prisco, Domenico; Vaglio, Augusto; Emmi, Giacomo;
• Other Names: Ahmad Kais investigator.; Beccalli Mirko investigator.; Bonnotte Bernard investigator.; Bortolotti Roberto investigator.; Cariddi Adriana investigator.; Caminati Marco investigator.; Cid Maria C investigator.; Deidda Margherita investigator.; Delvino Paolo investigator.; Scala Gerardo Di investigator.; Felicetti Mara investigator.; Ferro Francesco investigator.; Furini Federica investigator.; Gelain Elena investigator.; Ghirelli Giulia investigator.; Holle Julia investigator.; Losappio Laura Michelina investigator.; Mahr Alfred investigator.; Malandrino Danilo investigator.; Marhhold Juliane investigator.; Mattioli Irene investigator.; Moi Laura investigator.; Moiseev Sergey investigator.; Muratore Francesco investigator.; Nolasco Santi investigator.; Olivieri Bianca investigator.; Palermo Adalgisa investigator.; Regola Francesca investigator.; Sander Oliver investigator.; Scarpa Riccardo investigator.; Sciascia Savino investigator.; Silvestri Elena investigator.; Susca Nicola investigator.; Terrier Benjamin investigator.; Treppo Elena investigator.; Trezzi Barbara investigator.; Uzzo Martina investigator.; Vitiello Gianfranco investigator.; Yacyshyn Elaine investigator.;
• Is Part Of: Arthritis & rheumatology. Volume 74:Issue 2(2022)
• Page Start: 295
• Page End: 306
• Publication Date: 2021-12-30
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.41943
• Languages: English
• ISSNs: 2326-5191

Abstract

Abstract : Objective: Mepolizumab proved to be an efficacious treatment for eosinophilic granulomatosis with polyangiitis (EGPA) at a dose of 300 mg every 4 weeks in the randomized, controlled MIRRA trial. In a few recently reported studies, successful real‐life experiences with the approved dose for treating severe eosinophilic asthma (100 mg every 4 weeks) were observed. We undertook this study to assess the effectiveness and safety of mepolizumab 100 mg every 4 weeks and 300 mg every 4 weeks in a large European EGPA cohort. Methods: We included all patients with EGPA treated with mepolizumab at the recruiting centers in 2015–2020. Treatment response was evaluated from 3 months to 24 months after initiation of mepolizumab. Complete response to treatment was defined as no disease activity (Birmingham Vasculitis Activity Score [BVAS] = 0) and a prednisolone or prednisone dose (or equivalent) of ≤4 mg/day. Respiratory outcomes included asthma and ear, nose, and throat (ENT) exacerbations. Results: Two hundred three patients, of whom 191 received a stable dose of mepolizumab (158 received 100 mg every 4 weeks and 33 received 300 mg every 4 weeks) were included. Twenty‐five patients (12.3%) had a complete response to treatment at 3 months. Complete response rates increased to 30.4% and 35.7% at 12 months and 24 months, respectively, and rates were comparable between mepolizumab 100 mg every 4 weeks and 300 mg every 4 weeks. Mepolizumab led to a significant reduction in BVAS score, prednisone dose, and eosinophil counts from 3 months to 24 months, with no significant differences observed between 100 mg every 4 weeks and 300 mg every 4 weeks. Eighty‐two patients (40.4%) experienced asthma exacerbations (57 of 158 [36%] who received 100 mg every 4 weeks; 17 of 33 [52%] who received 300 mg every 4 weeks), and 31 patients (15.3%) experienced ENT exacerbations. Forty‐four patients (21.7%) experienced adverse events (AEs), most of which were nonserious AEs (38 of 44). Conclusion: Mepolizumab at both 100 mg every 4 weeks and 300 mg every 4 weeks is effective for the treatment of EGPA. The 2 doses should be compared in the setting of a controlled trial.