Clinical experience with anti-interleukin-5 monoclonal antibodies in the treatment of eosinophilic granulomatosis with polyangiitis.

Abstract

Objective: Eosinophilic granulomatosis with polyangiitis is a rare disease whose standard treatment includes systemic glucocorticoids, bronchodilators, and immunosuppressive agents. Mepolizumab and benralizumab have recently emerged as therapeutic alternatives. The aim of this study was to evaluate the effectiveness and treatment outcomes in real-world practice.

Methods: This retrospective observational study included 29 adult patients with eosinophilic granulomatosis with polyangiitis treated with mepolizumab and/or benralizumab at Hospital Universitario La Paz since 2017. Data were collected on oral glucocorticoid use, asthma therapies, immunosuppressive agents, eosinophil counts, and quality-of-life questionnaires to assess changes from baseline.

Results: The mean initial dose of prednisone was 15.4 mg per day. At six months, 60.9% of evaluable patients had reduced their dose, and at one year, glucocorticoids had been completely discontinued in 11 of 23 evaluable patients. Five patients continued on immunosuppressive therapy, while the rest discontinued it. Eosinophil counts decreased significantly at one year. Quality-of-life measures showed numerical improvements after one year of treatment.

Conclusion: In this real-world cohort, treatment with mepolizumab or benralizumab was associated with reduced glucocorticoid use and eosinophil counts. Some patients continued to require concomitant immunosuppressive therapy, particularly those with more complex disease presentations.