Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome
Background Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be incr...
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| Veröffentlicht in: | Journal of allergy and clinical immunology 2010-06, Vol.125 (6), p.1336-1343 |
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| container_title | Journal of allergy and clinical immunology |
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| creator | Kim, Sophia, MD Marigowda, Gautham, MD Oren, Eyal, MD Israel, Elliot, MD Wechsler, Michael E., MD |
| description | Background Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti–IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. Objective The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. Methods This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. Results Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. Conclusion Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability. |
| doi_str_mv | 10.1016/j.jaci.2010.03.028 |
| format | Article |
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Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti–IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. Objective The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. Methods This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. Results Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. Conclusion Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability.</description><identifier>ISSN: 0091-6749</identifier><identifier>EISSN: 1097-6825</identifier><identifier>DOI: 10.1016/j.jaci.2010.03.028</identifier><identifier>PMID: 20513524</identifier><identifier>CODEN: JACIBY</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenal Cortex Hormones - administration & dosage ; Adrenal Cortex Hormones - adverse effects ; Adult ; Allergy and Immunology ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - adverse effects ; Antibodies, Monoclonal, Humanized ; asthma ; Biological and medical sciences ; Cell Count ; Chronic obstructive pulmonary disease, asthma ; Churg-Strauss syndrome ; Churg-Strauss Syndrome - drug therapy ; Churg-Strauss Syndrome - immunology ; Churg-Strauss Syndrome - physiopathology ; Drug dosages ; Drug therapy ; eosinophilia ; Eosinophils - drug effects ; Eosinophils - pathology ; Family medical history ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Humans ; IL-5 ; Immunopathology ; Immunotherapy ; Male ; Medical records ; Medical sciences ; mepolizumab ; Middle Aged ; Patients ; Physicians ; Pilot Projects ; Pneumology ; Rheumatology ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Sinusitis ; steroid sparing ; Vasculitis ; Withholding Treatment ; Womens health</subject><ispartof>Journal of allergy and clinical immunology, 2010-06, Vol.125 (6), p.1336-1343</ispartof><rights>American Academy of Allergy, Asthma & Immunology</rights><rights>2010 American Academy of Allergy, Asthma & Immunology</rights><rights>2015 INIST-CNRS</rights><rights>Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jun 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c544t-c996656e1f49bbb3c897580ac7c42eee2e079f782072ad8396cf275c113d7cee3</citedby><cites>FETCH-LOGICAL-c544t-c996656e1f49bbb3c897580ac7c42eee2e079f782072ad8396cf275c113d7cee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jaci.2010.03.028$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22914494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20513524$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Sophia, MD</creatorcontrib><creatorcontrib>Marigowda, Gautham, MD</creatorcontrib><creatorcontrib>Oren, Eyal, MD</creatorcontrib><creatorcontrib>Israel, Elliot, MD</creatorcontrib><creatorcontrib>Wechsler, Michael E., MD</creatorcontrib><title>Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome</title><title>Journal of allergy and clinical immunology</title><addtitle>J Allergy Clin Immunol</addtitle><description>Background Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti–IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. Objective The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. Methods This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. Results Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. Conclusion Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability.</description><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adrenal Cortex Hormones - adverse effects</subject><subject>Adult</subject><subject>Allergy and Immunology</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal - adverse effects</subject><subject>Antibodies, Monoclonal, Humanized</subject><subject>asthma</subject><subject>Biological and medical sciences</subject><subject>Cell Count</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Churg-Strauss syndrome</subject><subject>Churg-Strauss Syndrome - drug therapy</subject><subject>Churg-Strauss Syndrome - immunology</subject><subject>Churg-Strauss Syndrome - physiopathology</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>eosinophilia</subject><subject>Eosinophils - drug effects</subject><subject>Eosinophils - pathology</subject><subject>Family medical history</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Humans</subject><subject>IL-5</subject><subject>Immunopathology</subject><subject>Immunotherapy</subject><subject>Male</subject><subject>Medical records</subject><subject>Medical sciences</subject><subject>mepolizumab</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Physicians</subject><subject>Pilot Projects</subject><subject>Pneumology</subject><subject>Rheumatology</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Sinusitis</subject><subject>steroid sparing</subject><subject>Vasculitis</subject><subject>Withholding Treatment</subject><subject>Womens health</subject><issn>0091-6749</issn><issn>1097-6825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk2LFDEQQIMo7rj6BzxIQMRTj0k66SQgggx-wYqH1YOnkE5X72bs7vQmaWX89aaZ0YU9eCpSvKpUPQqhp5RsKaHNq_12b53fMlISpN4Spu6hDSVaVo1i4j7aEKJp1Uiuz9CjlPakvGulH6IzRgStBeMb9P0zzGHwv5fRttgmbHHKEIPvqjTb6KcrnCPYPMKUcZizDxP2E55t9iWT8C-fr_HueolX1WWOdkkJp8PUxTDCY_Sgt0OCJ6d4jr69f_d197G6-PLh0-7tReUE57lyWjeNaID2XLdtWzulpVDEOuk4AwAGROpeKkYks52qdeN6JoWjtO6kA6jP0ctj3zmGmwVSNqNPDobBThCWZKTgqtGiUYV8fofchyVOZThDBeGKas1kodiRcjGkFKE3c_SjjQdDiVm9m71ZvZvVuyG1Kd5L0bNT66UdoftX8ld0AV6cAJucHfpoJ-fTLcc05Vyv3OsjB0XZTw_RJFdUO-h8BJdNF_z_53hzp9wNfvLlxx9wgHS7r0nMEHO5Xsh6ILTchiix_gNz1bWg</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Kim, Sophia, MD</creator><creator>Marigowda, Gautham, MD</creator><creator>Oren, Eyal, MD</creator><creator>Israel, Elliot, MD</creator><creator>Wechsler, Michael E., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SS</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20100601</creationdate><title>Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome</title><author>Kim, Sophia, MD ; Marigowda, Gautham, MD ; Oren, Eyal, MD ; Israel, Elliot, MD ; Wechsler, Michael E., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c544t-c996656e1f49bbb3c897580ac7c42eee2e079f782072ad8396cf275c113d7cee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adrenal Cortex Hormones - adverse effects</topic><topic>Adult</topic><topic>Allergy and Immunology</topic><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - adverse effects</topic><topic>Antibodies, Monoclonal, Humanized</topic><topic>asthma</topic><topic>Biological and medical sciences</topic><topic>Cell Count</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Churg-Strauss syndrome</topic><topic>Churg-Strauss Syndrome - drug therapy</topic><topic>Churg-Strauss Syndrome - immunology</topic><topic>Churg-Strauss Syndrome - physiopathology</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>eosinophilia</topic><topic>Eosinophils - drug effects</topic><topic>Eosinophils - pathology</topic><topic>Family medical history</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Humans</topic><topic>IL-5</topic><topic>Immunopathology</topic><topic>Immunotherapy</topic><topic>Male</topic><topic>Medical records</topic><topic>Medical sciences</topic><topic>mepolizumab</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Physicians</topic><topic>Pilot Projects</topic><topic>Pneumology</topic><topic>Rheumatology</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Sinusitis</topic><topic>steroid sparing</topic><topic>Vasculitis</topic><topic>Withholding Treatment</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Sophia, MD</creatorcontrib><creatorcontrib>Marigowda, Gautham, MD</creatorcontrib><creatorcontrib>Oren, Eyal, MD</creatorcontrib><creatorcontrib>Israel, Elliot, MD</creatorcontrib><creatorcontrib>Wechsler, Michael E., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of allergy and clinical immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Sophia, MD</au><au>Marigowda, Gautham, MD</au><au>Oren, Eyal, MD</au><au>Israel, Elliot, MD</au><au>Wechsler, Michael E., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome</atitle><jtitle>Journal of allergy and clinical immunology</jtitle><addtitle>J Allergy Clin Immunol</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>125</volume><issue>6</issue><spage>1336</spage><epage>1343</epage><pages>1336-1343</pages><issn>0091-6749</issn><eissn>1097-6825</eissn><coden>JACIBY</coden><abstract>Background Treatments for Churg-Strauss syndrome (CSS), a rare eosinophilic vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti–IL-5 antibody, decreases steroid requirements in patients with non-CSS hypereosinophilic syndromes. Objective The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. Methods This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. Results Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. Conclusion Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20513524</pmid><doi>10.1016/j.jaci.2010.03.028</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - adverse effects Adult Allergy and Immunology Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - adverse effects Antibodies, Monoclonal, Humanized asthma Biological and medical sciences Cell Count Chronic obstructive pulmonary disease, asthma Churg-Strauss syndrome Churg-Strauss Syndrome - drug therapy Churg-Strauss Syndrome - immunology Churg-Strauss Syndrome - physiopathology Drug dosages Drug therapy eosinophilia Eosinophils - drug effects Eosinophils - pathology Family medical history Female Fundamental and applied biological sciences. Psychology Fundamental immunology Humans IL-5 Immunopathology Immunotherapy Male Medical records Medical sciences mepolizumab Middle Aged Patients Physicians Pilot Projects Pneumology Rheumatology Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Sinusitis steroid sparing Vasculitis Withholding Treatment Womens health |
| title | Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome |
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