Mepolizumab-Related Blood Eosinophil Decreases Are Associated with Clinical Remission in Severe Asthmatic Patients: A Real-World Study.

IF 2.7 Q3 IMMUNOLOGY
Antibodies Pub Date : 2025-07-22 DOI:10.3390/antib14030061
Matteo Bonato, Francesca Savoia, Enrico Orzes, Elisabetta Favero, Gianenrico Senna, Micaela Romagnoli
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引用次数: 0

Abstract

Background: Mepolizumab is an effective treatment for severe eosinophilic asthma, leading to a depletion of blood eosinophil levels, the clinical relevance of which remains unclear. Objective: The aim of this study was to assess the relationship between mepolizumab-induced blood eosinophil reduction and clinical outcome in patients with severe eosinophilic asthma, in particular, whether the magnitude of blood eosinophil reduction was associated with clinical remission. Methods: We conducted a real-world retrospective analysis of 58 adult patients with severe eosinophilic asthma treated with mepolizumab. Clinical and respiratory functional parameters were evaluated at the start of mepolizumab treatment (T0) and after two years of treatment (T2; mean follow-up: 22.8 ± 7.5 months). Blood eosinophil counts were recorded at T0 and during the first year of treatment (T1; mean follow-up: 7.7 ± 4.1 months). Results: After two years of mepolizumab treatment, 58 severe asthmatic patients showed significant improvements in ACT score, FVC, and FEV1 and a reduction in acute exacerbations and the use of maintenance therapies. Clinical remission was achieved in 55.1% of patients. Lower blood eosinophil counts during the first year (T1) were associated with greater improvements in lung function and fewer exacerbations. A greater relative decrease in eosinophils from baseline to T1 (ΔEOS%) was significantly associated with remission, reductions in exacerbations, and no maintenance OCS use. ΔEOS% was the only independent predictor of remission in the multivariate analysis. A ≥90% reduction predicted remission with 80% specificity (AUC = 0.726). Conclusions: Monitoring blood eosinophils after mepolizumab initiation could be a useful tool for predicting long-term response to treatment. In particular, a reduction by over 90% of peripheral blood eosinophils during the first year of mepolizumab treatment predicts clinical remission with a specificity of 80%. Considering the accessibility and the low cost of this biomarker, it may help to optimize long-term asthma management.

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Abstract Image

mepolizumab相关的血嗜酸性粒细胞减少与严重哮喘患者的临床缓解相关:一项真实世界研究
背景:Mepolizumab是严重嗜酸性粒细胞哮喘的有效治疗方法,可导致血液嗜酸性粒细胞水平降低,其临床相关性尚不清楚。目的:本研究的目的是评估mepolizumab诱导的重度嗜酸性粒细胞哮喘患者的血嗜酸性粒细胞减少与临床结局之间的关系,特别是血嗜酸性粒细胞减少的幅度是否与临床缓解相关。方法:我们对58例接受mepolizumab治疗的严重嗜酸性粒细胞性哮喘成人患者进行了现实世界回顾性分析。在mepolizumab治疗开始时(T0)和治疗2年后(T2;平均随访时间:22.8±7.5个月)评估临床和呼吸功能参数。在T0和治疗第一年(T1,平均随访时间:7.7±4.1个月)记录血嗜酸性粒细胞计数。结果:经过两年的mepolizumab治疗,58例重症哮喘患者的ACT评分、FVC和FEV1均有显著改善,急性加重和维持治疗的使用均有所减少。55.1%的患者达到临床缓解。第一年(T1)较低的血嗜酸性粒细胞计数与肺功能的更大改善和更少的恶化有关。从基线到T1的嗜酸性粒细胞相对减少(ΔEOS%)与缓解、恶化减少和不使用维持性OCS显著相关。ΔEOS%是多变量分析中缓解的唯一独立预测因子。降低≥90%预示缓解,特异性为80% (AUC = 0.726)。结论:mepolizumab启动后监测血液嗜酸性粒细胞可能是预测长期治疗反应的有用工具。特别是,在mepolizumab治疗的第一年,外周血嗜酸性粒细胞减少90%以上,预测临床缓解的特异性为80%。考虑到这种生物标志物的可及性和低成本,它可能有助于优化长期哮喘管理。
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来源期刊
Antibodies
Antibodies IMMUNOLOGY-
CiteScore
7.10
自引率
6.40%
发文量
68
审稿时长
11 weeks
期刊介绍: Antibodies (ISSN 2073-4468), an international, peer-reviewed open access journal which provides an advanced forum for studies related to antibodies and antigens. It publishes reviews, research articles, communications and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. Full experimental and/or methodical details must be provided. Electronic files or software regarding the full details of the calculation and experimental procedure - if unable to be published in a normal way - can be deposited as supplementary material. This journal covers all topics related to antibodies and antigens, topics of interest include (but are not limited to): antibody-producing cells (including B cells), antibody structure and function, antibody-antigen interactions, Fc receptors, antibody manufacturing antibody engineering, antibody therapy, immunoassays, antibody diagnosis, tissue antigens, exogenous antigens, endogenous antigens, autoantigens, monoclonal antibodies, natural antibodies, humoral immune responses, immunoregulatory molecules.
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