Table 4 Case reports of mepolizumab for the management of ICEP
From: Monoclonal antibodies in idiopathic chronic eosinophilic pneumonia: a scoping review
Doses | Number of participants | Duration of follow-up after biological | Age/sex/Comorbidities | Outcomes | Case report reference | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Respiratory symptoms | Relapses | Systemic corticosteroid | Radiological findings | Lung function | Quality of life | Adverse events | |||||
100Â mg every 4 weeks. Benralizumab 30Â mg every 4 weeks for 3 doses, then every 8 weeks | 1 | 24 months Not described | Female, 58 years old. Severe asthma | Significant improvement at 4 months with ACT in control range After relapse improvement, keeping ACT in control range | None after start 1 relapse with onset | Tolerated slow decline with suspension at 12 months. Tolerated descent and suspension after relapse | Resolution at 4 months It had no alterations | Improvement at 4 months It had no alterations | Not described Not described | No adverse events during handling No adverse events during handling | Shimizu et al. 2020 [32]. |
100Â mg every 4 weeks for 6 months, then Reslizumab 3Â mg/kg every 4 weeks | 1 | 14 months | Female, 42 years old. Type 2 diabetes, smoker 28 pack-years, frequent relapses, Cushingoid facies, acne | Improvement at 2 weeks | None after initiation of mepolizumab, 1 relapse with Reslizumab | Dose reduction at 2 weeks, suspension at 2 months | Improvement after the start a | Not described | Not described | Injection site reaction and mild anaphylaxis with mepolizumab at 6 months was discontinued. No events with Reslizumab | Sarkis et al. 2020 [33]. |
100Â mg single dose | 1 | Not described | Female, 57 years old. Severe asthma, type I diabetes mellitus required bronchial thermoplasty | Improvement after treatment a | None after start a | Suspended, followed by starting the biological | Resolution after treatment a | Not described | Not described | Not described | Otoshi et al. 2020 [34]. |
100Â mg every 4 weeks | 1 | 7 months | Male, 45 years old. Asthma, cortico dependent | Improvement after the start a | None after start | Tolerated descent and withdrawal a | Not described | Not described | Not described | It caused the suspension of the biological, but they do not expand or characterize it | McKillion et al. 2021 [35]. |
Every 4 weeks, no dose mentioned | 1 | 9 months | Female, 38 years old. Major depression and anxiety. Insomnia and weight gain | Improvement after initiation being significant at month 8 | No relapses after initiation | Allows descent and suspension 5 months after initiation | Not described | Not described | Not described | Not described | Cyca et al. 2022 [36]. |
100Â mg every 4 weeks | 2 | 15 months 6 months | Case 1: Female, 56 years old. Type 2 Diabetes Mellitus Case 2: Male, 48 years old. Asthma, rhinitis, type 2 diabetes mellitus, depression | Improvement after the start a | None after start | Tolerated descent and withdrawal a | Normalization in X-ray and CT in both cases a | Case 1: FEV1 from 55% pretreatment to 85% posttreatment a Case 2: FEV1 from 60% pretreatment to 72% posttreatment a | Not described | Not described | Eldaabossi et al. 2021 [37]. |
100Â m every 4 weeks | 1 | 12 months | Female, 66 years old. Corticodependent asthma, atrial fibrillation, oxygen demanding, received management with Omalizumab without improvement | Improvement after the start, they withdraw oxygen a | None after start a | Tolerated descent and withdrawal a | Not described | Not described | Not described | Not described | Benipal et al. 2021 [38]. |
100Â mg every 4 weeks for 14 doses then every 8 weeks 100Â mg every 4 weeks for 12 doses then every 8 weeks | 2 | 36 months 24 months | Case 1: Male, 24 years old. Asthma No BAL or biopsy for diagnosis. Case 2: Female, 26 years old. Asthma Corticodependence | Improvement after the start a Improvement after the start a | None after start None after start | Tolerated decline with suspension at 10 months. Tolerated decline with suspension at 10 months | Complete resolution at 14 months, sustained at 36 months. Complete resolution at 12 months, sustained at 24 months | Improvement at 14 months, sustained at 36 months. Improvement at 12 months, sustained for 24 months | Not described Not described | No adverse events during handling No adverse events during handling | Sato et al. 2021 [39]. |
300Â mg every 4 weeks | 1 | 18 months | Female, 55 years old. Asthma, atopic dermatitis, rhinitis, anxiety. Corticosteroid intolerance | Improvement after treatment a | None after start a | Allows corticosteroid decrease | Not described | Not described | Not described | No adverse effects r | Kisling et al. 2020 [40]. |
No dose indicated | 1 | Not described | Female, 47 years old. Corticodependent | Improvement after treatment a | None after start a | Tolerated reduction and withdrawal a | Not described | Not described | Not described | Not described | Askin et al. 2020 [41]. |
100Â mg every 4 weeks | 1 | 10 months | Female, 59 years old. Asthma HTN, hyperglycemia, osteoporosis | Improvement after 3 months with ACT in adequate control | None after start | Not indicated. The biological was started | Resolution 3 months after starting treatment | Improvement after treatment a | Not described | No adverse events during handling | Ciuffreda et al. 2020 [42]. |
300Â mg every 4 weeks | 1 | Not described | Female, 55 years old. Asthma, anxiety, and steroid-related hallucinations | Improvement after the start a | Not described | Tolerated descent a | Not described | Not described | Not described | Not described | Jones et al. 2019 [43]. |
100Â mg every 4 weeks | 1 | 12 months | Female, 47 years old. Asthma, rhinitis. 3 relapses (2 in less than 6 weeks | Improvement after the start a | None after start | Tolerated descent and withdrawal a | Not described | Not described | Not described | Not described | McInnis et al. 2019 [44]. |
100 mg every 4 weeks | 2 | 2 months | Case 1: Female, 54 years old. Asthma, rhinitis, chronic rhinitis with nasal polyps, idiopathic thrombocytopenic purpura. Diagnosed in 2012. Two relapses Case 2: Female, 21 years old. Nonallergic asthma, rhinitis, sensorineural hearing loss. Diagnosed in 2015. Three relapses | Significant improvement 8 weeks after starting the biological | None after start | Case 1: Tolerated decline but is maintained by hematological comorbidity. Case 2: Tolerated decrease to 5 mg/alternate days prednisolone | Not described | Case 1: pretreatment FENO > 300 ppb, post treatment 157 ppb Case 2: not described | Not described | Not described | Mendes et al. 2019 [45]. |
Not describe doses. | 1 | 4 months | Female, 60 years old. Severe asthma, eosinophilic bronchiolitis | Improvement after the start a | No relapses after initiation | Not indicated, the biological was started | Improvement a | Improvement a | Not described | Not described | Tomyo & Sugimoto 2019 [46]. |
They do not describe doses. Vedolizumab continued | 1 | 6 months | Female, 49 years old. HBP, ulcerative colitis in management with vedolizumab and nodular prurigo, ex-smoker. Diagnosis by lung biopsy. Corticodependence | Significant improvement 7 days after onset | No relapses after initiation | Allows descent | Significant improvement at 6 months | Not described | Not described | No adverse events during handling | Lawrence et al. 2019 [47]. |
100Â mg every 4 weeks | 1 | 13 months | Male, 65 years old. Asthma relapses. | Resolution at 4 weeks | None after the start, continued with management | Not indicated. It was switched to the biological | Resolution 3 months after starting treatment | Not described | Not described | No adverse events during handling | To et al. 2018 [48]. |