BACKGROUND Currently,the mainstay of chronic eosinophilic pneumonia(CEP)treatment is corticosteroids,usually with a favorable response and good prognosis.However,relapse is common,requiring long-term use of corticoste...BACKGROUND Currently,the mainstay of chronic eosinophilic pneumonia(CEP)treatment is corticosteroids,usually with a favorable response and good prognosis.However,relapse is common,requiring long-term use of corticosteroids,with risk of significant treatment-related complications.The dire need to develop new treatments for patients with CEP,who are dependent on,or resistant to corticosteroids has led to exploring novel therapies.We herein describe a patient with acute relapse of CEP,who was successfully treated with benralizumab,an IL-5 Rαantagonist that has demonstrated rapid anti-eosinophil action in patients with asthma.Currently,only three recent patient reports on CEP relapse,also demonstrated successful treatment with benralizumab alone,without corticosteroids.CASE SUMMARY A 31-year-old non-smoking woman presented in our hospital with a 3 wk history of shortness of breath,dry cough and fever up to 38.3℃.Laboratory examination revealed leukocytosis 10240 K/μL,eosinophilia 900 K/μL and normal values of hemoglobin,platelets,creatinine and liver enzymes.Computed tomography of the chest showed a mediastinal lymphadenopathy and consolidations in the right upper and left lower lobes.CEP was diagnosed,and the patient was treated with hydrocortisone intravenously,followed by oral prednisone,with prompt improvement.Three months later,she presented with relapse of CEP:aggravation of dyspnea,rising of eosinophilia and extension of pulmonary infiltrates on chest X-ray.She was treated with benralizumab only,with clinical improvement within 2 wk,and complete resolution of lung infiltrates following 5 wk.CONCLUSION Due to Benralizumab’s dual mechanism of action,it both neutralizes IL-5 Rαpro-eosinophil functions and triggers apoptosis of eosinophils.We therefore maintain benralizumab can serve as a reasonable therapy choice for every patient with chronic eosinophilic pneumonia and a good alternative for corticosteroids.展开更多
Benralizumab is a monoclonal antibody that targets interleukin-5 receptor α to deplete blood eosinophils and improve the clinical outcomes of allergic asthma. We conducted a meta-analysis to evaluate the safety and e...Benralizumab is a monoclonal antibody that targets interleukin-5 receptor α to deplete blood eosinophils and improve the clinical outcomes of allergic asthma. We conducted a meta-analysis to evaluate the safety and efficacy of different doses of benralizumab in patients with eosinophilic asthma. All randomized controlled trials involving benralizumab treatment for patients with eosinophilic asthma, which were searched in PubMed, Embase, and the Cochrane Library published until January 2017, as well as the rate of asthmatic exacerbation, pulmonary functionality, asthma control, quality of life scores, and adverse events were included. Randomized-effect models were used in the meta-analysis to calculate the pooled mean difference, relative risks, and 95% confidence intervals. Five studies involving 1951 patients were identified. Compared with the placebo, benralizumab treatment demonstrated significant improvements in the forced expiratory volume in 1 s （FEV1）, Asthma Quality of Life Questionnaire scores, decreased asthmatic exacerbation and Asthma Control Questionnaire-6 （ACQ-6） scores. Benralizumab treatment was also not associated with increased adverse events. These findings indicated that benralizumab can be safely used to improve FEV1, enhance patient symptom control and quality of life, and reduce the risk of exacerbations and ACQ-6 scores in patients with eosinophilic asthma. Furthermore, our meta-analysis showed that benralizumab with 30 mg （every eight weeks） dosage can improve the health-related quality of life and appear to be more effective than 30 mg （every four weeks） dosage. Overall, data indicated that the optimal dosing regimen for benralizumab was possibly 30 mg （every eight weeks）.展开更多
BACKGROUND Benralizumab is a monoclonal antibody targeting the IL-5 receptor used in the treatment of asthma.The use of benralizumab in other conditions is only emerging and could represent a therapeutic option for ot...BACKGROUND Benralizumab is a monoclonal antibody targeting the IL-5 receptor used in the treatment of asthma.The use of benralizumab in other conditions is only emerging and could represent a therapeutic option for other eosinophil-associated diseases.Here,we report the case of a patient suffering from eosinophilic esophagitis and asthma who achieved histological remission of eosinophilic esophagitis(EoE)under benralizumab treatment for his asthma.CASE SUMMARY Our patient was a 56-year-old white male with a history of eosinophilic esophagitis and severe asthma.After years of usual treatments,including topical steroids,biological treatment with mepolizumab,and standard asthma treatment,only poor control of both conditions was obtained.A control gastroscopy after the initiation of benralizumab showed complete histological remission of his EoE.CONCLUSION Our case shows the effects of therapy with a novel agent not yet approved for this condition but for other diseases,with histological resolution of EoE after treatment.Complete clinical remission was not observed,which exemplifies the complex nature of EoE,its associated psychosomatic burden,and the chronification of the disease.Nevertheless,monoclonal antibodies targeting the Th2 response and,in our case,an IL5 receptor antagonist,achieved complete histological remission,which was not the case with an antibody against IL-5,which was also initiated to treat asthma.展开更多
目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组...目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组)对比安慰剂+常规治疗(对照组)的随机对照试验,检索时限均为建库起至2020年12月,并同时手工检索相关研究的参考文献。对符合纳入标准的研究进行资料提取后,采用Cochrane系统评价员手册6.1推荐的偏倚评估工具2.0版本对纳入文献的质量进行评价。采用Rev Man 5.4软件进行Meta分析。结果:共纳入5项研究,合计2646例患者。Meta分析结果显示,试验组患者的哮喘急性发作率[RR=0.67,95%CI(0.61,0.74),P<0.00001]、哮喘控制问卷评分[MD=-0.29,95%CI(-0.37,-0.21),P<0.00001]、严重不良事件发生率[RR=0.67,95%CI(0.53,0.84),P=0.0006]均显著低于对照组,第1秒用力呼气量[MD=0.13,95%CI(0.09,0.17),P<0.00001]、哮喘生活质量问卷评分[MD=0.23,95%CI(0.13,0.33),P<0.00001]均显著高于对照组,而两组患者的不良事件发生率比较差异无统计学意义[RR=0.97,95%CI(0.92,1.02),P=0.28]。结论:贝那利珠单抗治疗重度嗜酸粒细胞性哮喘患者安全、有效。但因数据相对有限,该结论还有待更多的研究来证实。展开更多
文摘BACKGROUND Currently,the mainstay of chronic eosinophilic pneumonia(CEP)treatment is corticosteroids,usually with a favorable response and good prognosis.However,relapse is common,requiring long-term use of corticosteroids,with risk of significant treatment-related complications.The dire need to develop new treatments for patients with CEP,who are dependent on,or resistant to corticosteroids has led to exploring novel therapies.We herein describe a patient with acute relapse of CEP,who was successfully treated with benralizumab,an IL-5 Rαantagonist that has demonstrated rapid anti-eosinophil action in patients with asthma.Currently,only three recent patient reports on CEP relapse,also demonstrated successful treatment with benralizumab alone,without corticosteroids.CASE SUMMARY A 31-year-old non-smoking woman presented in our hospital with a 3 wk history of shortness of breath,dry cough and fever up to 38.3℃.Laboratory examination revealed leukocytosis 10240 K/μL,eosinophilia 900 K/μL and normal values of hemoglobin,platelets,creatinine and liver enzymes.Computed tomography of the chest showed a mediastinal lymphadenopathy and consolidations in the right upper and left lower lobes.CEP was diagnosed,and the patient was treated with hydrocortisone intravenously,followed by oral prednisone,with prompt improvement.Three months later,she presented with relapse of CEP:aggravation of dyspnea,rising of eosinophilia and extension of pulmonary infiltrates on chest X-ray.She was treated with benralizumab only,with clinical improvement within 2 wk,and complete resolution of lung infiltrates following 5 wk.CONCLUSION Due to Benralizumab’s dual mechanism of action,it both neutralizes IL-5 Rαpro-eosinophil functions and triggers apoptosis of eosinophils.We therefore maintain benralizumab can serve as a reasonable therapy choice for every patient with chronic eosinophilic pneumonia and a good alternative for corticosteroids.
文摘Benralizumab is a monoclonal antibody that targets interleukin-5 receptor α to deplete blood eosinophils and improve the clinical outcomes of allergic asthma. We conducted a meta-analysis to evaluate the safety and efficacy of different doses of benralizumab in patients with eosinophilic asthma. All randomized controlled trials involving benralizumab treatment for patients with eosinophilic asthma, which were searched in PubMed, Embase, and the Cochrane Library published until January 2017, as well as the rate of asthmatic exacerbation, pulmonary functionality, asthma control, quality of life scores, and adverse events were included. Randomized-effect models were used in the meta-analysis to calculate the pooled mean difference, relative risks, and 95% confidence intervals. Five studies involving 1951 patients were identified. Compared with the placebo, benralizumab treatment demonstrated significant improvements in the forced expiratory volume in 1 s （FEV1）, Asthma Quality of Life Questionnaire scores, decreased asthmatic exacerbation and Asthma Control Questionnaire-6 （ACQ-6） scores. Benralizumab treatment was also not associated with increased adverse events. These findings indicated that benralizumab can be safely used to improve FEV1, enhance patient symptom control and quality of life, and reduce the risk of exacerbations and ACQ-6 scores in patients with eosinophilic asthma. Furthermore, our meta-analysis showed that benralizumab with 30 mg （every eight weeks） dosage can improve the health-related quality of life and appear to be more effective than 30 mg （every four weeks） dosage. Overall, data indicated that the optimal dosing regimen for benralizumab was possibly 30 mg （every eight weeks）.
文摘BACKGROUND Benralizumab is a monoclonal antibody targeting the IL-5 receptor used in the treatment of asthma.The use of benralizumab in other conditions is only emerging and could represent a therapeutic option for other eosinophil-associated diseases.Here,we report the case of a patient suffering from eosinophilic esophagitis and asthma who achieved histological remission of eosinophilic esophagitis(EoE)under benralizumab treatment for his asthma.CASE SUMMARY Our patient was a 56-year-old white male with a history of eosinophilic esophagitis and severe asthma.After years of usual treatments,including topical steroids,biological treatment with mepolizumab,and standard asthma treatment,only poor control of both conditions was obtained.A control gastroscopy after the initiation of benralizumab showed complete histological remission of his EoE.CONCLUSION Our case shows the effects of therapy with a novel agent not yet approved for this condition but for other diseases,with histological resolution of EoE after treatment.Complete clinical remission was not observed,which exemplifies the complex nature of EoE,its associated psychosomatic burden,and the chronification of the disease.Nevertheless,monoclonal antibodies targeting the Th2 response and,in our case,an IL5 receptor antagonist,achieved complete histological remission,which was not the case with an antibody against IL-5,which was also initiated to treat asthma.
文摘目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组)对比安慰剂+常规治疗(对照组)的随机对照试验,检索时限均为建库起至2020年12月,并同时手工检索相关研究的参考文献。对符合纳入标准的研究进行资料提取后,采用Cochrane系统评价员手册6.1推荐的偏倚评估工具2.0版本对纳入文献的质量进行评价。采用Rev Man 5.4软件进行Meta分析。结果:共纳入5项研究,合计2646例患者。Meta分析结果显示,试验组患者的哮喘急性发作率[RR=0.67,95%CI(0.61,0.74),P<0.00001]、哮喘控制问卷评分[MD=-0.29,95%CI(-0.37,-0.21),P<0.00001]、严重不良事件发生率[RR=0.67,95%CI(0.53,0.84),P=0.0006]均显著低于对照组,第1秒用力呼气量[MD=0.13,95%CI(0.09,0.17),P<0.00001]、哮喘生活质量问卷评分[MD=0.23,95%CI(0.13,0.33),P<0.00001]均显著高于对照组,而两组患者的不良事件发生率比较差异无统计学意义[RR=0.97,95%CI(0.92,1.02),P=0.28]。结论:贝那利珠单抗治疗重度嗜酸粒细胞性哮喘患者安全、有效。但因数据相对有限,该结论还有待更多的研究来证实。
