Daiki Sakai, Kaichi Kaneko, Karin Furukawa, Mai Kawazoe, Yasuo Matsuzawa, Toshihiro Nanki
{"title":"与传统免疫抑制剂相比,Mepolizumab用于嗜酸性肉芽肿病合并多血管炎患者可减少糖皮质激素剂量并改善残留症状:一项回顾性观察性研究","authors":"Daiki Sakai, Kaichi Kaneko, Karin Furukawa, Mai Kawazoe, Yasuo Matsuzawa, Toshihiro Nanki","doi":"10.1007/s00296-025-05991-4","DOIUrl":null,"url":null,"abstract":"<p><p>Mepolizumab (MPZ) is an anti-interleukin-5 monoclonal antibody used to treat eosinophilic granulomatosis with polyangiitis (EGPA). This study aimed to compare the efficacy of MPZ and conventional treatment (CT) for EGPA after maintenance therapy initiation. In this retrospective, observational study, patients diagnosed with EGPA meeting these criteria were included: prednisolone ≤ 20 mg/day, Birmingham Vasculitis Activity Score (BVAS) < 10, and MPZ or new CT initiation ≥ 6 months after initial treatment were included (MPZ: n = 16; CT: n = 16). BVAS, relapse-free survival, absolute eosinophil count, cumulative glucocorticoids (GC) dose, and GC toxicity index (GTI) were evaluated for up to 12 months. Multivariable linear regression for BVAS and logistic regression for relapse at 12 months were performed, adjusting for age, gender, disease duration, and baseline eosinophil count. In the MPZ group, BVAS at 12 months significantly decreased, while BVAS tended to be lower in the MPZ than in the CT group at 12 months. Participants achieving BVAS = 0 significantly increased in the MPZ group at 12 months. Relapse rates tended to be lower in the MPZ group. Absolute eosinophil counts decreased in the MPZ compared with the CT group from 1 to 12 months. Cumulative GC dose and GTI significantly decreased in the MPZ group vs. CT group. In multivariable analyses, the use of MPZ was suggestive of lower BVAS and lower odds of relapse at 12 months compared with CT, although these differences were not statistically significant. MPZ could be a potential treatment option for reducing GC or improving residual symptoms in patients with EGPA.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 10","pages":"229"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mepolizumab in patients with eosinophilic granulomatosis with polyangiitis reduced glucocorticoid dose and improved residual symptoms compared to conventional immunosuppressants: a retrospective observational study.\",\"authors\":\"Daiki Sakai, Kaichi Kaneko, Karin Furukawa, Mai Kawazoe, Yasuo Matsuzawa, Toshihiro Nanki\",\"doi\":\"10.1007/s00296-025-05991-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Mepolizumab (MPZ) is an anti-interleukin-5 monoclonal antibody used to treat eosinophilic granulomatosis with polyangiitis (EGPA). This study aimed to compare the efficacy of MPZ and conventional treatment (CT) for EGPA after maintenance therapy initiation. In this retrospective, observational study, patients diagnosed with EGPA meeting these criteria were included: prednisolone ≤ 20 mg/day, Birmingham Vasculitis Activity Score (BVAS) < 10, and MPZ or new CT initiation ≥ 6 months after initial treatment were included (MPZ: n = 16; CT: n = 16). BVAS, relapse-free survival, absolute eosinophil count, cumulative glucocorticoids (GC) dose, and GC toxicity index (GTI) were evaluated for up to 12 months. Multivariable linear regression for BVAS and logistic regression for relapse at 12 months were performed, adjusting for age, gender, disease duration, and baseline eosinophil count. In the MPZ group, BVAS at 12 months significantly decreased, while BVAS tended to be lower in the MPZ than in the CT group at 12 months. Participants achieving BVAS = 0 significantly increased in the MPZ group at 12 months. Relapse rates tended to be lower in the MPZ group. Absolute eosinophil counts decreased in the MPZ compared with the CT group from 1 to 12 months. Cumulative GC dose and GTI significantly decreased in the MPZ group vs. CT group. In multivariable analyses, the use of MPZ was suggestive of lower BVAS and lower odds of relapse at 12 months compared with CT, although these differences were not statistically significant. MPZ could be a potential treatment option for reducing GC or improving residual symptoms in patients with EGPA.</p>\",\"PeriodicalId\":21322,\"journal\":{\"name\":\"Rheumatology International\",\"volume\":\"45 10\",\"pages\":\"229\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Rheumatology International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00296-025-05991-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rheumatology International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00296-025-05991-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Mepolizumab in patients with eosinophilic granulomatosis with polyangiitis reduced glucocorticoid dose and improved residual symptoms compared to conventional immunosuppressants: a retrospective observational study.
Mepolizumab (MPZ) is an anti-interleukin-5 monoclonal antibody used to treat eosinophilic granulomatosis with polyangiitis (EGPA). This study aimed to compare the efficacy of MPZ and conventional treatment (CT) for EGPA after maintenance therapy initiation. In this retrospective, observational study, patients diagnosed with EGPA meeting these criteria were included: prednisolone ≤ 20 mg/day, Birmingham Vasculitis Activity Score (BVAS) < 10, and MPZ or new CT initiation ≥ 6 months after initial treatment were included (MPZ: n = 16; CT: n = 16). BVAS, relapse-free survival, absolute eosinophil count, cumulative glucocorticoids (GC) dose, and GC toxicity index (GTI) were evaluated for up to 12 months. Multivariable linear regression for BVAS and logistic regression for relapse at 12 months were performed, adjusting for age, gender, disease duration, and baseline eosinophil count. In the MPZ group, BVAS at 12 months significantly decreased, while BVAS tended to be lower in the MPZ than in the CT group at 12 months. Participants achieving BVAS = 0 significantly increased in the MPZ group at 12 months. Relapse rates tended to be lower in the MPZ group. Absolute eosinophil counts decreased in the MPZ compared with the CT group from 1 to 12 months. Cumulative GC dose and GTI significantly decreased in the MPZ group vs. CT group. In multivariable analyses, the use of MPZ was suggestive of lower BVAS and lower odds of relapse at 12 months compared with CT, although these differences were not statistically significant. MPZ could be a potential treatment option for reducing GC or improving residual symptoms in patients with EGPA.
期刊介绍:
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.