Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma

Severe eosinophilic asthma (SEA) is associated with high peripheral blood and airway eosinophilia, recurrent disease exacerbations and severe airflow limitation. Eosinophilic inflammation is also responsible for small airway disease (SAD) development. SEA patients experience poor disease control and...

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Autores principales:	Angelantonio Maglio, Carolina Vitale, Simona Pellegrino, Cecilia Calabrese, Maria D’Amato, Antonio Molino, Corrado Pelaia, Massimo Triggiani, Girolamo Pelaia, Cristiana Stellato, Alessandro Vatrella
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	severe asthma mepolizumab eosinophils lung function FEF25-75 ACT Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/75cb49082e334b6f9ca52940d0d6f952
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spelling	oai:doaj.org-article:75cb49082e334b6f9ca52940d0d6f9522021-11-25T16:48:54ZReal-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma10.3390/biomedicines91115502227-9059https://doaj.org/article/75cb49082e334b6f9ca52940d0d6f9522021-10-01T00:00:00Zhttps://www.mdpi.com/2227-9059/9/11/1550https://doaj.org/toc/2227-9059Severe eosinophilic asthma (SEA) is associated with high peripheral blood and airway eosinophilia, recurrent disease exacerbations and severe airflow limitation. Eosinophilic inflammation is also responsible for small airway disease (SAD) development. SEA patients experience poor disease control and response to standard therapy and are prime candidates for anti-IL5 biologicals, such as mepolizumab, but the effect of treatment on SAD is unclear. We investigated the effect of mepolizumab on lung function in SEA patients, focusing on SAD parameters, and searched for an association between patients’ phenotypic characteristics and changes in small airways function. In this real-life study, data from 105 patients with SEA were collected at baseline and after 6, 12 and 18 months of mepolizumab treatment. Along with expected improvements in clinical and lung function parameters brought by Mepolizumab treatment, FEF2525-75% values showed a highly significant, gradual and persistent increase (from 32.7 ± 18.2% at baseline to 48.6 ± 18.4% after 18 months) and correlated with ACT scores at 18 months (r = 0.566; <i>p</i> ≤ 0.0001). A patient subgroup analysis showed that changes in FEF25-75% values were higher in patients with a baseline peripheral blood eosinophil count ≥400 cells/μL and oral corticosteroid use. Mepolizumab significantly improves small airway function. This effect correlates with clinical benefits and may represent an accessible parameter through which to evaluate therapeutic response. This study provides novel insights into the phenotypic characteristics associated with the improved functional outcome provided by mepolizumab treatment.Angelantonio MaglioCarolina VitaleSimona PellegrinoCecilia CalabreseMaria D’AmatoAntonio MolinoCorrado PelaiaMassimo TriggianiGirolamo PelaiaCristiana StellatoAlessandro VatrellaMDPI AGarticlesevere asthmamepolizumabeosinophilslung functionFEF25-75ACTBiology (General)QH301-705.5ENBiomedicines, Vol 9, Iss 1550, p 1550 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	severe asthma mepolizumab eosinophils lung function FEF25-75 ACT Biology (General) QH301-705.5
spellingShingle	severe asthma mepolizumab eosinophils lung function FEF25-75 ACT Biology (General) QH301-705.5 Angelantonio Maglio Carolina Vitale Simona Pellegrino Cecilia Calabrese Maria D’Amato Antonio Molino Corrado Pelaia Massimo Triggiani Girolamo Pelaia Cristiana Stellato Alessandro Vatrella Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
description	Severe eosinophilic asthma (SEA) is associated with high peripheral blood and airway eosinophilia, recurrent disease exacerbations and severe airflow limitation. Eosinophilic inflammation is also responsible for small airway disease (SAD) development. SEA patients experience poor disease control and response to standard therapy and are prime candidates for anti-IL5 biologicals, such as mepolizumab, but the effect of treatment on SAD is unclear. We investigated the effect of mepolizumab on lung function in SEA patients, focusing on SAD parameters, and searched for an association between patients’ phenotypic characteristics and changes in small airways function. In this real-life study, data from 105 patients with SEA were collected at baseline and after 6, 12 and 18 months of mepolizumab treatment. Along with expected improvements in clinical and lung function parameters brought by Mepolizumab treatment, FEF2525-75% values showed a highly significant, gradual and persistent increase (from 32.7 ± 18.2% at baseline to 48.6 ± 18.4% after 18 months) and correlated with ACT scores at 18 months (r = 0.566; <i>p</i> ≤ 0.0001). A patient subgroup analysis showed that changes in FEF25-75% values were higher in patients with a baseline peripheral blood eosinophil count ≥400 cells/μL and oral corticosteroid use. Mepolizumab significantly improves small airway function. This effect correlates with clinical benefits and may represent an accessible parameter through which to evaluate therapeutic response. This study provides novel insights into the phenotypic characteristics associated with the improved functional outcome provided by mepolizumab treatment.
format	article
author	Angelantonio Maglio Carolina Vitale Simona Pellegrino Cecilia Calabrese Maria D’Amato Antonio Molino Corrado Pelaia Massimo Triggiani Girolamo Pelaia Cristiana Stellato Alessandro Vatrella
author_facet	Angelantonio Maglio Carolina Vitale Simona Pellegrino Cecilia Calabrese Maria D’Amato Antonio Molino Corrado Pelaia Massimo Triggiani Girolamo Pelaia Cristiana Stellato Alessandro Vatrella
author_sort	Angelantonio Maglio
title	Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
title_short	Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
title_full	Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
title_fullStr	Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
title_full_unstemmed	Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma
title_sort	real-life effectiveness of mepolizumab on forced expiratory flow between 25% and 75% of forced vital capacity in patients with severe eosinophilic asthma
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/75cb49082e334b6f9ca52940d0d6f952
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Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma

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