The experience of using mepolizumab in severe bronchial asthma


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. The treatment of patients with severe bronchial asthma using monoclonal antibody preparations against key cytokines involved in the development of asthma is a new area of therapy and requires careful selection of patients based on clinical features and biological markers. Currently, five biological preparations have been registered in the Russian Federation for the treatment of patients with the T2-endotype of bronchial asthma, the clinical experience of their use, in particular mepolizumab, is relatively limited. Description of the clinical case. A female patient with uncontrolled severe bronchial asthma at the step 5 treatment (high doses of inhaled glucocorticosteroids, long-acting P2-adrenoagonists, long-acting anticholinergics, oral glucocorticosteroids), with elevated eosinophilic inflammation biomarker levels (blood eosinophils, total IgE), and low lung function received drug mepolizumab during the year in addition to baseline therapy. Conclusion. As a result of treatment, an improvement in disease control and quality of life was observed; it was possible to reduce the dose of oral glucocorticosteroids by more than 2 times and significantly reduce the use of healthcare resources.

Full Text

Restricted Access

About the authors

G. R Sergeeva

North-Western State Medical University n.a. I.I. Mechnikov

A. A Znakhurenko

North-Western State Medical University n.a. I.I. Mechnikov

E. V Leshenkova

North-Western State Medical University n.a. I.I. Mechnikov

A. V Emelyanov

North-Western State Medical University n.a. I.I. Mechnikov

Email: aleksandr.emelyanov@szgmu.ru
MD, Professor

References

  1. Chung K.F., Wenzel S.E., Brozek J.L., et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343-73. doi: 10.1183/09031936.00202013.
  2. Global Initiative for asthma. NHLB/WHO Workshop Report-National Heart Lung Blood Institute, updated 2019. www.ginasthma.org. Access 17.04.2019.
  3. Бронхиальная астма. Федеральные клинические рекомендации. 2019.
  4. Haldar P, Brightling C.E., Hargadon B., et al. Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med. 2009;360:973-84. doi: 10.1056/NEJMoa0808991.
  5. Pavord I.D., Korn S., Howarth P, et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebocontrolled trial. Lancet. 2012;380:651-59. Doi: 10.1016/ S0140-6736(12)60988-X.
  6. Ortega H.G., Liu M.C., Pavord I.D., et al. Mepolizumab treatment in patients with severe eo-sinophilic asthma. N Engl J Med. 2014;371:1198-207. Doi: 10.1056/ NEJMoa1403290.
  7. Nair P., Pizzichini M., Kjarsgaard M., et al. Mepolizumab for prednison-dependent asthma with sputum eosinophilia. N. Engl J. Med. 2009;360:985-93. Doi: 10.1056/ NEJMoa0805435.
  8. Khurana S., Brusselle G.G., Bel E.H., et al. Longterm Safety and Clinical Benefit of Mepoli-zumab in Patients With the Most Severe Eosinophilic Asthma: the COSMEX Study. Clin Ther. 2019;pii: S0149-2918(19)30350-9. Doi: 10.1016/j. clinthera.2019.07.007.
  9. Bel E.H., Wenzel S.E., Thompson P.J., et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N. Engl J. Med. 2014;371:1189-97. Doi: 10.1056/ NEJMoa1403291.
  10. Lugogo N., Domingo C., Chanez P., et al. longterm Efficacy and Safety of Mepolizumab in Patients With Severe Eosinophilic Asthma: A Multicenter, Open-label, Phase IIIb Study. Clin Ther. 2016;38(9):2058-2070.e1. Doi: 10.1016/j. clinthera.2016.07.010.
  11. Albers F.C., Ortega H., Bradford E.S., et al. Durability of clinical response following longterm treatment with mepolizumab in patients with severe eosinophilic asthma: the COLUMBA study Presented at the American Thoracic Society International Conference, San Diego, CA, USA. 2018;18-23.
  12. Ortega H.G., Albers F.C., Bradford E.S., et al. Long-term Safety of Mepolizumab in Patients With Severe Eosinophilic Asthma: The COLUMBA Study Presented at the American Thoracic Society International Conference, San Diego, CA, USA. 2018;18-23. Poster No. P892 (A1367).
  13. Инструкция по медицинскому применению препарата Нукала.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2019 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies