Analysis of the economically justifiable price of mepolizumab in adults with asthma in Colombia

Journal of Asthma, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 11

Published: Jan. 21, 2025

Asthma imposes a critical economic burden on health systems, especially with the incorporation of new drugs. Recently, mepolizumab has been approved to prevent exacerbations in patients eosinophilic asthma, however their high cost constitutes barrier for use, middle- and low-income countries. This study aimed estimate economically justifiable price preventing severe asthma Colombia. A model was developed using microsimulation quality-adjusted costs life years two interventions: versus not applying standard treatment without mepolizumab. analysis made during lifetime horizon from third-payer perspective. We analyzed recent willingness pay (WTP) estimates Colombia ($4,828 $5,128) $19,992, equivalent up three times GDP per capita, as previously used conjunction mentioned above. At current US$781 dose 100 mg mepolizumab, this drug is cost-effective WTP U$4828, U$ 5128, U$19 992 QALY. Based thresholds $4,828, $5,128, $19,992 QALY assessed study, were determined be $147, $165, $691 dose, respectively. The between $147 depending used. result should encourage more studies region that optimize decision-making processes when incorporating into plans each country.

Language: Английский

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The Role of Ubiquitin-Proteasome System (UPS) in Asthma Pathology

Journal of Asthma and Allergy, Journal Year: 2025, Volume and Issue: Volume 18, P. 307 - 330

Published: Feb. 28, 2025

Asthma represents a major global health concern, underscoring an imperative for further exploration into its pathogenesis to inform the development of more effective treatment strategies. As key mechanism intracellular protein degradation and regulation, ubiquitin-proteasome system (UPS) plays crucial but complex multifaceted role in pathological process asthma. This study systematically reviews functions mechanisms E3 ubiquitin ligases deubiquitinases within UPS The explores impact these on occurrence inflammation alteration airway hyperresponsiveness by regulating synthesis release inflammatory factors, as well proliferation or differentiation cells. A comprehensive understanding asthma will help provide new theoretical basis potential drug targets precision treatment, which holds great promise future.

Language: Английский

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Head‐To‐Head Comparison of Biologic Efficacy in Asthma: What Have We Learned?

Allergy, Journal Year: 2025, Volume and Issue: unknown

Published: March 29, 2025

We performed an in-depth appraisal of indirect head-to-head comparisons biologics approved for asthma, including anti-IL5/5Rα (mepolizumab, benralizumab), anti-IL4Rα (dupilumab), anti-TSLP (tezepelumab) and anti-IgE (omalizumab), which was neither a systematic review nor meta-analysis. A crude evaluation 95% CI's rate ratios excluded unity revealed greater overall reductions in annualised exacerbations with dupilumab versus either mepolizumab or benralizumab also tezepelumab benralizumab. Furthermore patients eosinophils ≥ 300/μL exacerbation rates were lower tezepelumab, benralizumab; eosinophils< 150/μL dupilumab. For lung function, no differences FEV1 response observed between drugs where there considerable heterogeneity overlapping CI's. Dupilumab superior to oscillometry-derived peripheral resistance compliance, as well attenuation mannitol airway hyperresponsiveness. There asthma control quality life scores the effect sizes small, along wide overlaps is unmet need prospective pragmatic randomised controlled trials directly compare biologics, especially assess clinical remission both type 2 high low patients. Real-life studies might evaluate complete different include outcomes such inhaled corticosteroid sparing, small airways dysfunction using oscillometry, abolition hyperresponsiveness mucus plugging remodelling wall thickening imaging.

Language: Английский

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IgE‐Mediated Activation of Mast Cells and Basophils in Health and Disease

Immunological Reviews, Journal Year: 2025, Volume and Issue: 331(1)

Published: March 31, 2025

Type 2-mediated immune responses protect the body against environmental threats at barrier surfaces, such as large parasites and toxins, facilitate repair of inflammatory tissue damage. However, maladaptive to typically nonpathogenic substances, commonly known allergens, can lead development allergic diseases. 2 immunity involves a series prototype TH2 cytokines (IL-4, IL-5, IL-13) alarmins (IL-33, TSLP) that promote generation adaptive CD4+ helper cells humoral products allergen-specific IgE. Mast basophils are integral players in this network, serving primary effectors IgE-mediated responses. These bind IgE via high-affinity receptors (FcεRI) expressed on their surface and, upon activation by release variety mediators regulate responses, attract modulate other cells, contribute repair. Here, we review biology effector mechanisms these focusing primarily role mediating both physiological pathological contexts.

Language: Английский

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Impact of the COVID-19 Pandemic on ACO Prevalence Among AECOPD Patients (2019-2023) and Clinical Characteristics by Blood Eosinophil Levels

International Journal of COPD, Journal Year: 2025, Volume and Issue: Volume 20, P. 1051 - 1060

Published: April 1, 2025

This study aimed to evaluate changes in the prevalence of Asthma-COPD Overlap (ACO) among patients with Acute Exacerbations COPD (AECOPD) from 2019 2023. It also compared clinical characteristics across EOS thresholds (50, 150, and 300 cells/μL) identify disease severity markers guide individualized treatment strategies. Clinical data AECOPD ACO hospitalized at Second Hospital Hebei Medical University between January December 2023 were analyzed. Patients grouped by levels cells/μL), their compared. Among 408 275 patients, during late pandemic period was significantly higher than pre-pandemic 2019. showed increased counts FeNO (P < 0.05). In those <50 cells/μL had lower lymphocyte NLR FDP other groups. Similarly, group levels. ≥300 younger exhibited 50-150 groups <0.05). The period, possibly indicating a role for type 2 inflammation. 50, may serve as aid tailoring

Language: Английский

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Biologicals reduce drug burden and improve physical and mental health in severe eosinophilic asthma

Journal of Asthma, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 6

Published: April 15, 2025

This real-world study evaluates the improvement in asthma control, drug burden reduction, and physical mental health patients with severe eosinophilic treated biologicals. We enrolled 127 from two centers, treating them add-on biological therapy. The control test (ACT) Short-form Health Survey-12 (SF-12), including Physical Component Summary (PCS) Mental (MCS), were used, assessing history at baseline (T0) after 32 weeks of therapy (T1). A significant was observed treatment (ACT score: 11(8) vs 23(3), p < 0.0001), most achieving T1 (110, 86.6%). There a statistically reduction use non-biological drugs T1, such as oral corticosteroids (40.2% 17.3%, inhalation (75.6% 57.5%, = 0.001), leukotriene receptor antagonists (34.6% 25.2%, antihistamines (42.5% 18.1%, 0.0001). ACT PCS scores had strong positive correlation (r 0.749, did MCS 0.744, Our shows that treatments for asthma, properly characterized through careful phenotypic assessment, significantly improve reduce (notably corticosteroids, therapy, antagonists, antihistamines), well enhance both irrespective age sex.

Language: Английский

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Successful switch to tezepelumab for severe asthma and chronic rhinosinusitis with nasal polyps

Asia Pacific Allergy, Journal Year: 2025, Volume and Issue: unknown

Published: May 2, 2025

Chronic rhinosinusitis with nasal polyp (CRSwNP) is a type 2 inflammatory disease frequently associated asthma. Patients CRSwNP are typically treated endoscopic sinus surgery and oral corticosteroids. However, they often experience recurrence; in addition, corticosteroids have several adverse effects. an important factor influencing asthma control, total control of both for treatment. Dupilumab mepolizumab, which anti-interleukin (IL)-4R anti-IL-5 monoclonal antibodies, respectively, been approved the treatment severe CRSwNP. Here, we discuss successful patient comorbid after switching from dupilumab mepolizumab to tezepelumab. The was initially high-dose inhaled corticosteroids/long-acting β2-agonist/long-acting muscarinic antagonist treatment, without success. Treatment improved CRSwNP; however, it later induced hypereosinophilia exacerbated Although subsequent asthma, symptoms recurred. After attempting again, improved; worsened parallel increased eosinophil count. Finally, antithymic stromal lymphopoietin antibody tezepelumab, selected treatment; worsening then This report illustrates potential utility tezepelumab Tezepelumab therapy may enhance comorbidities upper lower airways. Further studies required identify effective therapies

Language: Английский

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Efficacy of different biologics for treating chronic rhinosinusitis with nasal polyps: a network meta-analysis

European Archives of Oto-Rhino-Laryngology, Journal Year: 2024, Volume and Issue: 282(2), P. 559 - 569

Published: Aug. 26, 2024

Language: Английский

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Integrative epidemiology and immuno-transcriptomics uncover a risk and potential mechanism for cutaneous lymphoma unmasking or progression with dupilumab therapy

Journal of Allergy and Clinical Immunology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

There have been multiple reports of the anti-IL-4Rα agent, dupilumab, being associated with onset and/or progression cutaneous T-cell lymphoma (CTCL).

Language: Английский

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Baseline Characteristics of Patients Enrolled in Clinical Trials of Biologics for Severe Asthma as Potential Predictors of Outcomes

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(4), P. 1546 - 1546

Published: Feb. 15, 2023

(1) Background: Over the past 20 years, monoclonal antibodies have been developed for treatment of severe asthma, with numerous randomised controlled trials (RCTs) conducted to define their safety and efficacy. The growing availability biologics, which until now only available T2-high has further enriched by arrival tezepelumab. (2) Methods: This review aims evaluate baseline characteristics patients enrolled in RCTs biologics asthma understand how they could potentially predict outcomes can help differentiate between options. (3) Results: studies reviewed demonstrated that all biologic agents are effective improving control, especially regard reducing exacerbation rates OCS use. As we seen, this regard, there few data on omalizumab none yet In analysing exacerbations average doses OCSs, pivotal benralizumab more seriously ill patients. Secondary outcomes, such as improvement lung function quality life, showed better results—especially dupilumab (4) Conclusion: Biologics effective, albeit important differences. What fundamentally guides choice is patient’s clinical history, endotype represented biomarkers (especially blood eosinophils), comorbidities nasal polyposis).

Language: Английский

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