From DREAM to REALITI‐A and beyond: Mepolizumab for the treatment of eosinophil‐driven diseases

Allergy, Год журнала: 2021, Номер 77(3), С. 778 - 797

Опубликована: Авг. 17, 2021

Abstract Effective treatment of inflammatory diseases is often challenging owing to their heterogeneous pathophysiology. Understanding the underlying disease mechanisms improving and it now clear that eosinophils play a complex pathophysiological role in broad range type 2 diseases. Standard care for these conditions still includes oral corticosteroids (OCS) and/or cytotoxic immune therapies, which are associated with debilitating side effects. Selective, biological eosinophil‐reducing agents provide options improve clinical symptoms eosinophilic inflammation reduce OCS use. Mepolizumab humanized monoclonal antibody binds neutralizes interleukin‐5, major cytokine involved eosinophil proliferation, activation, survival. approved severe asthma, granulomatosis polyangiitis hypereosinophilic syndrome. Additionally, efficacy add‐on mepolizumab has been observed patients chronic rhinosinusitis nasal polyposis obstructive pulmonary an phenotype. Here, we review development, approval, real‐world effectiveness from DREAM REALITI‐A studies, describe how knowledge this journey extended use other biologics across spectrum

Язык: Английский

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Dupilumab for chronic obstructive pulmonary disease with type 2 inflammation: a pooled analysis of two phase 3, randomised, double-blind, placebo-controlled trials

The Lancet Respiratory Medicine, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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Prevalence and Clinical Outcomes of Eosinophilic COPD in a Saudi Population: A Retrospective Study

Saudi Journal of Medicine and Medical Sciences, Год журнала: 2025, Номер 13(1), С. 53 - 60

Опубликована: Янв. 1, 2025

This study assessed the prevalence of eosinophilic chronic obstructive pulmonary disease (COPD) among a selected Saudi population and examined its correlation with baseline characteristics, clinical outcomes, exacerbation risk, current management. retrospective single-center was conducted over 2-year period. The patients were divided into two groups based on blood eosinophil count at time diagnosis: COPD (≥300 cells/μl) non-eosinophilic (<300 groups. Overall, 156 included, which 76 (48.7%) 80 (51.3%) belonged to groups, respectively. There no significant differences between both regarding age, gender, smoking status, coexisting morbidities, FEV1, FEV1/FVC, severity (for all, P >0.05). Besides, there frequency numbers exacerbations, emergency room visits, in-patient hospitalizations, intensive care unit admissions Among COPD, 64 (84.2%) correctly receiving triple therapy long-acting β2 agonists + muscarinic antagonist inhaled corticosteroids, whereas 4 (5.26%) incorrectly dual corticosteroids. Univariate regression analyses revealed that heart failure, GOLD 3 severity, use therapy, non-invasive ventilation significantly correlated higher risk exacerbation. Conversely, FEV1 lower phenotype not found be independent variable clinically important relationship rate

Язык: Английский

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Personalized COPD Care: The Future of Precision-Based Therapies

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(21), С. 6339 - 6339

Опубликована: Окт. 23, 2024

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory illness characterized by long-standing symptoms and airflow limitation. It major contributor to disease-related deaths currently ranked as the sixth leading cause of mortality in United States. Approved pharmacological therapies for stable primarily consist inhaled short long-acting bronchodilators, corticosteroids, azithromycin, roflumilast. In recent years, significant progress has been made management COPD through identification different phenotypes endotypes, which allows more personalized treatment approach. While earlier studies investigating targeted were less promising, data on drugs targeting type 2 inflammatory pathways have shown promising results carefully selected patients. this article, we will review available well ongoing clinical novel COPD. Understanding implementing these advancements hold promise improving outcomes quality life individuals living with

Язык: Английский

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Role of peripheral eosinophilia in acute exacerbation of chronic obstructive pulmonary disease

World Journal of Clinical Cases, Год журнала: 2020, Номер 8(13), С. 2727 - 2737

Опубликована: Июль 4, 2020

Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease (COPD).To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation COPD (AECOPD).From January 2014 May 2017, AECOPD Taipei Tzu Chi Hospital were retrospectively stratified into two groups according their eosinophil count: The EOS group (eosinophil count ≥ 2%) and non-EOS < 2%). Demographics, comorbidities, laboratory data, use, length hospital stay, COPD-related readmissions compared between groups.A total 625 recruited, 176 (28.2%) group. showed lower prevalence infection, cumulative doses prednisolone equivalents, shorter higher number than There significantly linear correlations percentage stay (P 0.001, Pearson's r = 0.147; P 0.031, -0.086, respectively). percent-predicted value forced expiratory volume one second (FEV1) associated time first readmission [adjusted hazard ratio (adj. HR) 1.488, 0.001; adj. HR 0.985, respectively].The findings suggest that had features steroids, but more frequent readmissions. FEV1 values risk factors readmission.

Язык: Английский

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Real-World Investigation of Eosinophilic-Associated Disease Overlap (REVEAL): Analysis of a US Claims Database

Allergy Asthma and Immunology Research, Год журнала: 2023, Номер 15(5), С. 580 - 580

Опубликована: Янв. 1, 2023

The epidemiology of eosinophil-associated diseases (EADs) is not yet fully understood. While some studies have been conducted on stand-alone eosinophilic diseases, there scarce evidence the degree overlap among rarer conditions.The retrospective Real-world inVestigation Eosinophilic-Associated disease overLap (REVEAL) study used data from Optum® Clinformatics® insurance claims database to describe and characterize 11 EADs: allergic bronchopulmonary aspergillosis, atopic dermatitis, chronic rhinosinusitis with nasal polyps, gastritis/gastroenteritis, granulomatosis polyangiitis, esophagitis, bullous pemphigoid, obstructive pulmonary disorder, spontaneous urticaria, non-cystic fibrosis bronchiectasis. Patient records EADs interest were identified between January 1, 2015, June 30, 2018.Overall, 1,326,645 patients included; 74.4% had 1 EAD, 20.5% ≥ 2 EADs, 5.1% 3 EADs. Higher rates associated older age. blood eosinophil counts also observed in a greater number overlapping conditions, suggesting common role for inflammation pathogenesis multiple diseases. Furthermore, was higher severity most cohorts.Results this implications quantifying unmet needs can be inform treatment guidelines raise awareness EAD healthcare professionals range specialties.

Язык: Английский

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Clinical evaluation of pulmonary quantitative computed tomography parameters for diagnosing eosinophilic chronic obstructive pulmonary disease: Characteristics and diagnostic performance

Health Science Reports, Год журнала: 2024, Номер 7(3)

Опубликована: Март 1, 2024

Abstract Aims To investigate the characteristics and diagnostic performance of quantitative computed tomography (QCT) parameters in eosinophilic chronic obstructive pulmonary disease (COPD) patients. Methods High‐resolution CT scans COPD patients were retrospectively analyzed, various emphysematous parenchyma measurements, including lung volume (LC), mean density (LMD), standard deviation (LSD), full‐width half maximum (FWHM), relative voxel number (LRVN) performed. The QCT compared between noneosinophilic patients, using a definition as blood eosinophil values ≥ 300 cells·µL −1 on at least three times. Receiver operating characteristic curves area under curve (ROC‐AUC) python used to evaluate discriminative efficacy QCT. Results Noneosinophilic had significantly lower TLMD (−846.3 ± 47.9 Hounsfield Unit [HU]) TFWHM(162.5 30.6 HU) (−817.8 54.4, 177.3 33.1 HU, respectively) ( p = 0.018, 0.03, respectively). Moreover, total LC (TLC) TLSD group (3234.4 1145.8, 183.8 33.9 than (5600.2 1248.4, 203.5 20.4 0.009, 0.002, ROC‐AUC for TLC, TLMD, TLSD, TFWHM 0.91 (95% confidence interval [CI], 0.828–0.936), 0.66 CI, 0.546–0.761), 0.64 0.524–0.742), 0.63 0.511–0.731), respectively. When TLC value was 4110 mL, sensitivity 90.7% 79.7–96.9), specificity 77.8% 57.7–91.4) accuracy 86.4%. Notably, demonstrated highest efficiency with an F1 Score 0.79, Odds Ratio 34.3 Matthews Correlation Coefficient 0.69, surpassing (0.55, 3.66, 0.25), (0.56, 3.95, 0.26), 4.16, 0.33). Conclusion Eosinophilic exhibit levels emphysema more uniform distribution throughout lungs Furthermore, may serve valuable marker distinguishing two groups.

Язык: Английский

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Blood eosinophil variability in patients presenting with acute exacerbations of COPD within the past year and its correlation with treatment plan

Egyptian Journal of Bronchology, Год журнала: 2024, Номер 18(1)

Опубликована: Март 26, 2024

Abstract Background Chronic obstructive pulmonary disease (COPD) is an acknowledged contributor to universal fatality and morbidity. Using biomarkers pinpoint its phenotypes crucial, enabling individualized treatment enhancing prognosis. Objective Studying the steadiness of blood eosinophi1s in cases who experienced repeated hospital admissions for acute worsening COPD during a year correlation plan. Methods A retrospective cohort study includes 270 male patients with exacerbations. The were divided into three groups: fluctuating (ranges between ≥ 150 cells/ul < cells/ul), non-EOS (< Eosinophil (EOS) (≥ cells/ul). Results Most EOS group (53.3%). median length stay was longer (5 days). There significant positive number exacerbations both count EOS/WBCs. higher eosinophilic associated increased risk used steroids (higher group, 61.6%). Conclusion Blood promising investigating Peripheral eosinophilia relevant biomarker directing management exacerbations, including steroids.

Язык: Английский

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Eosinophilic inflammation: a key player in COPD pathogenesis and progression

Annals of Medicine, Год журнала: 2024, Номер 56(1)

Опубликована: Окт. 7, 2024

Chronic Obstructive Pulmonary Disease (COPD) remains a significant public health challenge due to its high morbidity and mortality rates. Emerging research has identified eosinophilic inflammation as crucial factor in the pathogenesis exacerbation of COPD, warranting detailed exploration underlying mechanisms therapeutic implications.

Язык: Английский

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Nanoparticle-Induced Airway Eosinophilia Is Independent of ILC2 Signaling but Associated With Sex Differences in Macrophage Phenotype Development

The Journal of Immunology, Год журнала: 2021, Номер 208(1), С. 110 - 120

Опубликована: Ноя. 24, 2021

Abstract The majority of lung diseases occur with a sex bias in terms prevalence and/or severity. Previous studies demonstrated that, compared males, female mice develop greater eosinophilic inflammation the airways after multiwalled carbon nanotube (MWCNT) exposure. However, mechanism by which this occurs is unknown. Two immune cells that could account for are type II innate lymphoid (ILC2s) and alveolar macrophages (AMs). In order to determine cell was responsible MWCNT-induced airway eosinophil recruitment subsequent differences disease, male C57BL/6 were exposed MWCNTs (2 mg/kg) via oropharyngeal aspiration, respiratory response assessed 7 d later. Greater eosinophilia eotaxin 2 levels observed MWCNT-treated females corresponded changes hyperresponsiveness than those males. females, there significant increase frequency ILC2s within lungs control animals. depletion α-CD90.2 administration did not decrease 24 h MWCNT AMs isolated from animals M2a macrophage phenotype gene expression, ex vivo cytokine production, activation (p)STAT6 upregulated significantly degree Our findings suggest AM development, ILC2 signaling, inhalation.

Язык: Английский

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