Dataset Information

An International, Retrospective Study of Off-Label Biologic Use in the Treatment of Hypereosinophilic Syndromes.

ABSTRACT:

Background

Treatment of hypereosinophilic syndrome (HES) often requires the use of immunomodulators with substantial side effect profiles. The emergence of biologics offers an alternative treatment modality.

Objective

To examine real-world practice data to describe the safety and consequences of various biologics suspected to directly or indirectly affect eosinophilic inflammation for the treatment of HES.

Methods

Retrospective data from 13 centers were collected via an online Research Electronic Data Capture repository. Inclusion criteria included (1) peripheral eosinophil count of 1,500/mm³ or greater without a secondary cause; (2) clinical manifestations attributable to the eosinophilia; and (3) having received mepolizumab (anti-IL-5), benralizumab (afucosylated anti-IL-5 receptor α), omalizumab (anti-IgE), alemtuzumab (anti-CD52), dupilumab (anti-IL-4 receptor α), or reslizumab (anti-IL-5) outside a placebo-controlled clinical trial.

Results

Of the 151 courses of biologics prescribed for 121 patients with HES, 59% resulted in improved HES symptoms and 77% enabled tapering of other HES medications. Overall, 105 patients were receiving daily systemic glucocorticoids at the time of a biologic initiation and were able to reduce the glucocorticoid dose by a median reduction of 10 mg of daily prednisone equivalents. Biologics were generally safe and well-tolerated other than infusion reactions with alemtuzumab. Thirteen of 24 patients had clinical improvement after switching biologics and nine patients responded to increasing the dose of mepolizumab after a lack of response to a lower dose.

Conclusions

Biologics may offer a safer treatment alternative to existing therapies for HES, although the optimal dosing and choice for each subtype of HES remain to be determined. Limitations of this study include its retrospective nature and intersite differences in data collection and availability of each biologic.

SUBMITTER: Chen MM

PROVIDER: S-EPMC9086180 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

An International, Retrospective Study of Off-Label Biologic Use in the Treatment of Hypereosinophilic Syndromes.

Chen Michael M MM Roufosse Florence F Wang Sa A SA Verstovsek Srdan S Durrani Sandy R SR Rothenberg Marc E ME Pongdee Thanai T Butterfield Joseph J Lax Timothy T Wechsler Michael E ME Stein Miguel L ML Ogbogu Princess U PU Kahwash Basil M BM Mathur Sameer K SK Simon Dagmar D Akuthota Praveen P Holland Nicole N Wetzler Lauren L Ware JeanAnne M JM Guo Canting C Fay Michael P MP Khoury Paneez P Klion Amy D AD Bochner Bruce S BS

The journal of allergy and clinical immunology. In practice 20220215 5

<h4>Background</h4>Treatment of hypereosinophilic syndrome (HES) often requires the use of immunomodulators with substantial side effect profiles. The emergence of biologics offers an alternative treatment modality.<h4>Objective</h4>To examine real-world practice data to describe the safety and consequences of various biologics suspected to directly or indirectly affect eosinophilic inflammation for the treatment of HES.<h4>Methods</h4>Retrospective data from 13 centers were collected via an onl ...[more]

PMID: 35181548

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Dataset Information

An International, Retrospective Study of Off-Label Biologic Use in the Treatment of Hypereosinophilic Syndromes.

Background

Objective

Methods

Results

Conclusions

Publications

An International, Retrospective Study of Off-Label Biologic Use in the Treatment of Hypereosinophilic Syndromes.

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