Safety of dupilumab in T2 airways conditions: focus on eosinophilia across trials and real-life evidence

Caminati, Marco; Micheletto, Claudio; Norelli, Francesca; Olivieri, Bianca; Ottaviano, Giancarlo; Padoan, Roberto; Piacentini, Giorgio; Schiappoli, Michele; Senna, Gianenrico; Menzella, Francesco

doi:10.1080/14712598.2024.2304556

Cited by 3 publications

(2 citation statements)

References 65 publications

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“…The available data confirms the safety profile of dupilumab. 65 Moreover, in terms of cost-to-benefit ratio, the benefits linked to the prescription of dupilumab must not be underestimated because patients eligible for biologic treatment are affected by difficult-to-treat pathologies that require high amounts of systemic steroids. Clinically significant hypereosinophilia related to dupilumab administration is rare, whilst systemic steroid damage is frequent and has a great impact on economic costs and patient health.…”

Section: Discussionmentioning

confidence: 99%

Severe hypereosinophilia in a patient treated with dupilumab and shift to mepolizumab: the importance of multidisciplinary management. A case report and literature review

Munari,

Ciotti,

Cestaro

et al. 2024

DIC

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Type 2 inflammation is a heterogeneous condition due to the complex activation of different immunological pathways. Rapid progress in research to evaluate the efficacy of biologics for chronic rhinosinusitis with nasal polyps and asthma has led to the availability of effective therapeutic options. These drugs are safe, but temporary iatrogenic hypereosinophilia may sometimes be associated with clinical symptoms or organ damage. Here, we describe a case of severe hypereosinophilia in a patient with chronic rhinosinusitis with nasal polyps and asthma treated with dupilumab and a subsequent therapeutic shift to mepolizumab that led to maintenance of symptom control and concomitant normalization of blood eosinophil count.

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Section: Discussionmentioning

confidence: 99%

Severe hypereosinophilia in a patient treated with dupilumab and shift to mepolizumab: the importance of multidisciplinary management. A case report and literature review

Munari,

Ciotti,

Cestaro

et al. 2024

DIC

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“…Однако необходимо отметить, что преходящее повышение эозинофилов обычно незначительно с клинической точки зрения и связано с механизмом действия лекарственного препарата. В ходе проводимых исследований и клинических наблюдений также сообщалось о редких случаях гиперэозинофилии, связанной с такими клиническими состояниями, как ЭГПА и гиперэозинофильный синдром, причем данные случаи связаны со стероидсберегающим эффектом препарата или естественным течением основного заболевания, а не с прямой причинно-следственной связью с терапией дупилумабом [10].…”

Section: Discussionunclassified

Blood eosinophilia in patients with severe bronchial asthma and chronic polypous rhinosinusitis treated with dupilumab: A review

Petukhova,

Gromov,

Solovyov

et al. 2024

Terapevticheskii arkhiv

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Bronchial asthma and chronic polypous rhinosinusitis are diseases associated with a T2-inflammatory immune response. These nosologies can be combined, creating the preconditions for a more severe course of multimorbidity, requiring the use of genetic engineering biological therapy. Dupilumab is a monoclonal antibody that can specifically bind to the alpha subunit of the interleukin-4 receptor and block the action of interleukins 4 and 13, which play a key role in the development of T2 inflammation. Numerous studies have demonstrated the high effectiveness of this medicament. The use of dupilumab in some cases may be accompanied by an increase in eosinophils in the blood. This article presents scientific base and our own experience in treating patients with dupilumab-associated eosinophilia, in addition we describe an algorithm for examining this group of patients for the purpose of timely diagnosis of diseases such as eosinophilic granulomatosis with polyangiitis, eosinophilic pneumonia, etc. It should be noted that in the most cases eosinophilia during targeted therapy with dupilumab is temporary and does not cause clinical manifestations.

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The Impact of Dupilumab on Work Productivity and Emotional Health in CRSwNP: A Multicentric Study in Northeast Italy

Ottaviano,

Roccuzzo,

Lora

et al. 2024

JPM

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Chronic rhinosinusitis with nasal polyps (CRSwNP) in the severe forms is associated with a poor quality of life. Dupilumab has been suggested as an add-on treatment option for severe CRSwNP. Severe CRSwNP patients treated with Dupilumab in different rhinological units were considered for this study via their evaluation at the baseline at first and the consequential follow-up at 6-, 12-, and 24 months from the first administration. At baseline (T0) and at each follow-up, patients underwent NPS, Sinonasal Outcome Test (SNOT)-22, Visual Analogue Scale (VAS) for smell, and Sniffin’ sticks identification test (SSIT). The SNOT-22 domains for function and emotion were also analysed separately. Two hundred and seventeen patients with at least 6 months of follow-up were included. All parameters have improved during treatment (p < 0.0001). Noticeably, both the function and emotion SNOT-22 domains have improved within 6 months of treatment and have continued to progress during every interval within 12 months from the baseline, positively influencing patients’ emotivity and augmenting their social and economic performances. Dupilumab improves the QoL of CRSwNP patients with good effects on the reported productivity and emotional health. Clinicians should pay attention to these two aspects when dealing with patients affected by severe CRSwNP.

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Safety of dupilumab in T2 airways conditions: focus on eosinophilia across trials and real-life evidence

Cited by 3 publications

References 65 publications

Severe hypereosinophilia in a patient treated with dupilumab and shift to mepolizumab: the importance of multidisciplinary management. A case report and literature review

Severe hypereosinophilia in a patient treated with dupilumab and shift to mepolizumab: the importance of multidisciplinary management. A case report and literature review

Blood eosinophilia in patients with severe bronchial asthma and chronic polypous rhinosinusitis treated with dupilumab: A review

The Impact of Dupilumab on Work Productivity and Emotional Health in CRSwNP: A Multicentric Study in Northeast Italy

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