Effect of Dupilumab on Blood Eosinophil Counts in Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps, Atopic Dermatitis, or Eosinophilic Esophagitis. - Université de Lille Accéder directement au contenu
Article Dans Une Revue The Journal of Allergy and Clinical Immunology: In Practice Année : 2022

Effect of Dupilumab on Blood Eosinophil Counts in Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps, Atopic Dermatitis, or Eosinophilic Esophagitis.

Michael E. Wechsler
  • Fonction : Auteur
Amy D. Klion
  • Fonction : Auteur
Pierluigi Paggiaro
  • Fonction : Auteur
Parameswaran Nair
  • Fonction : Auteur
Amr Radwan
  • Fonction : Auteur
Robert R. Johnson
  • Fonction : Auteur
Upender Kapoor
  • Fonction : Auteur
Faisal A. Khokhar
  • Fonction : Auteur
Nadia Daizadeh
  • Fonction : Auteur
Zhen Chen
  • Fonction : Auteur
Elizabeth Laws
  • Fonction : Auteur
Benjamin Ortiz
  • Fonction : Auteur
Juby A. Jacob-Nara
  • Fonction : Auteur
Paul J. Rowe
  • Fonction : Auteur
Yamo Deniz
  • Fonction : Auteur

Résumé

Background Transient increases in blood eosinophil counts have been observed in dupilumab clinical trials. Objective To assess eosinophil counts and eosinophilia-related treatment-emergent adverse events (TEAEs) across 11 dupilumab clinical trials, comparing adult and adolescent patients with asthma and adult patients with chronic rhinosinusitis with nasal polyps (CRSwNP), atopic dermatitis, and eosinophilic esophagitis. Methods Eosinophil counts, rates of eosinophilia-related TEAEs or treatment-emergent eosinophilia (>1,500 cells/μL), discontinuations, clinical symptoms, and efficacy in patients with asthma or CRSwNP with treatment-emergent eosinophilia are presented. Results Transient increases in mean eosinophil counts were observed in dupilumab-treated patients with asthma (mean range across studies at baseline: 349-370 cells/μL; week 4: 515-578 cells/μL), CRSwNP (baseline: 440-448 cells/μL; week 16: 595 cells/μL), and atopic dermatitis (baseline: 434-600 cells/μL; week 4: 410-710 cells/μL), followed by a decline starting by week 24 to baseline or lower. No increases were seen in patients with eosinophilic esophagitis (baseline: 310 cells/μL; week 4: 230 cells/μL). In dupilumab-treated patients across all studies, rates of eosinophilia TEAEs were 0% to 13.6%. Clinical symptoms associated with increased eosinophils were rare (seven of 4,666 dupilumab-treated patients, including six cases of eosinophilic granulomatosis with polyangiitis) and occurred only in patients with asthma or CRSwNP. Eosinophilia was not associated with reduced dupilumab efficacy. Conclusions Transient increases in eosinophil counts with dupilumab treatment did not affect efficacy and were rarely of clinical consequence. It remains important for physicians to base judgment on individual patient history and baseline eosinophil counts and to be alert to hypereosinophilic symptoms.
Fichier principal
Vignette du fichier
PIIS2213219822005074.pdf (2.04 Mo) Télécharger le fichier
Origine : Publication financée par une institution
Licence : CC BY NC ND - Paternité - Pas d'utilisation commerciale - Pas de modification

Dates et versions

hal-04437953 , version 1 (14-02-2024)

Licence

Paternité - Pas d'utilisation commerciale - Pas de modification

Identifiants

Citer

Michael E. Wechsler, Amy D. Klion, Pierluigi Paggiaro, Parameswaran Nair, Delphine Staumont, et al.. Effect of Dupilumab on Blood Eosinophil Counts in Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps, Atopic Dermatitis, or Eosinophilic Esophagitis.. The Journal of Allergy and Clinical Immunology: In Practice, 2022, The Journal of Allergy and Clinical Immunology: In Practice, 10 (10), pp.P2695-2709. ⟨10.1016/j.jaip.2022.05.019⟩. ⟨hal-04437953⟩

Collections

RIIP UNIV-LILLE
6 Consultations
3 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More