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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... Full description

Journal Title: Journal of allergy and clinical immunology 2010, Vol.125 (6), p.1336-1343
Main Author: Kim, Sophia, MD
Other Authors: Marigowda, Gautham, MD , Oren, Eyal, MD , Israel, Elliot, MD , Wechsler, Michael E., MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0091-6749
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recordid: cdi_proquest_miscellaneous_754869568
title: Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome
format: Article
creator:
  • Kim, Sophia, MD
  • Marigowda, Gautham, MD
  • Oren, Eyal, MD
  • Israel, Elliot, MD
  • Wechsler, Michael E., MD
subjects:
  • Adrenal Cortex Hormones - administration & dosage
  • Adrenal Cortex Hormones - adverse effects
  • Adult
  • Allergy and Immunology
  • Antibodies
  • Antibodies, Monoclonal - administration & dosage
  • Antibodies, Monoclonal - adverse effects
  • Antibodies, Monoclonal, Humanized
  • asthma
  • Biological and medical sciences
  • Blood
  • C-reactive protein
  • Care and treatment
  • 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 examination
  • Medical records
  • Medical sciences
  • mepolizumab
  • Middle Aged
  • Nitrogen oxide
  • Patients
  • Physicians
  • Pilot Projects
  • Pneumology
  • Rheumatology
  • Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
  • Sinusitis
  • steroid sparing
  • Vasculitis
  • Viral antibodies
  • Withholding Treatment
  • Womens health
ispartof: Journal of allergy and clinical immunology, 2010, Vol.125 (6), p.1336-1343
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.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0091-6749
fulltext: fulltext
issn:
  • 0091-6749
  • 1097-6825
url: Link


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titleMepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome
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descriptionBackground 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.
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subjectAdrenal Cortex Hormones - administration & dosage ; Adrenal Cortex Hormones - adverse effects ; Adult ; Allergy and Immunology ; Antibodies ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - adverse effects ; Antibodies, Monoclonal, Humanized ; asthma ; Biological and medical sciences ; Blood ; C-reactive protein ; Care and treatment ; 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 examination ; Medical records ; Medical sciences ; mepolizumab ; Middle Aged ; Nitrogen oxide ; Patients ; Physicians ; Pilot Projects ; Pneumology ; Rheumatology ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Sinusitis ; steroid sparing ; Vasculitis ; Viral antibodies ; Withholding Treatment ; Womens health
ispartofJournal of allergy and clinical immunology, 2010, Vol.125 (6), p.1336-1343
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0American Academy of Allergy, Asthma & Immunology
12010 American Academy of Allergy, Asthma & Immunology
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3Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
4COPYRIGHT 2010 Elsevier B.V.
5Copyright Elsevier Limited Jun 2010
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1Marigowda, Gautham, MD
2Oren, Eyal, MD
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descriptionBackground 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.
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5Antibodies, Monoclonal - administration & dosage
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7Antibodies, Monoclonal, Humanized
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11C-reactive protein
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13Cell Count
14Chronic obstructive pulmonary disease, asthma
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16Churg-Strauss Syndrome - drug therapy
17Churg-Strauss Syndrome - immunology
18Churg-Strauss Syndrome - physiopathology
19Drug dosages
20Drug therapy
21eosinophilia
22Eosinophils - drug effects
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24Family medical history
25Female
26Fundamental and applied biological sciences. Psychology
27Fundamental immunology
28Humans
29IL-5
30Immunopathology
31Immunotherapy
32Male
33Medical examination
34Medical records
35Medical sciences
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37Middle Aged
38Nitrogen oxide
39Patients
40Physicians
41Pilot Projects
42Pneumology
43Rheumatology
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45Sinusitis
46steroid sparing
47Vasculitis
48Viral antibodies
49Withholding Treatment
50Womens health
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titleMepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome
authorKim, Sophia, MD ; Marigowda, Gautham, MD ; Oren, Eyal, MD ; Israel, Elliot, MD ; Wechsler, Michael E., MD
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6Antibodies, Monoclonal - adverse effects
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abstractBackground 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.
copNew York, NY
pubElsevier Inc
pmid20513524
doi10.1016/j.jaci.2010.03.028