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Real-Life Study of Mepolizumab in Idiopathic Chronic Eosinophilic Pneumonia

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Abstract

Introduction

Idiopathic chronic eosinophilic pneumonia (ICEP) is an orphan lung disease characterized by concomitant systemic and local eosinophilia, along with bilateral lung infiltrates. Symptoms include dyspnea of subacute/chronic onset, cough, and general systemic signs. Although all patients do respond to oral corticosteroids, relapse rate is very high, which highlights the need for alternative therapies in case of relapsing ICEP. Mepolizumab is a fully humanized antibody directed against interleukin 5, a key growth factor of eosinophils. In the present study, we retrospectively studied the effect of off-label use of mepolizumab for relapsing ICEP.

Materials and Methods

All data from patients treated with mepolizumab for relapsing ICEP were included in our database and diagnoses were reviewed. We analyzed the effect of treatment on relapse rate, oral corticosteroids (OCS) use, and lung lesions on high-resolution computed tomography (HRCT).

Results

We included ten patients in the final analysis, with a median follow-up of 9 months after initiation of mepolizumab. Beside its expected effect on circulating eosinophils, treatment with mepolizumab was associated with a significant reduction of annual rate of exacerbations and a reduced consumption of corticosteroids. We also observed a remission of lung lesions on follow-up HRCT.

Conclusions

In this open-label retrospective study, treatment of ICEP with mepolizumab was associated with a reduction of relapses, OCS use, and the disappearance of lung infiltrates.

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Abbreviations

ICEP:

Idiopathic chronic hypereosinophilic pneumonia

HRCT:

High-resolution computed tomography

OCS:

Oral corticosteroids

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Correspondence to Antoine Froidure.

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Conflict of interest

The authors have no conflict of interest related to this manuscript.

Ethical Approval

The retrospective analysis of data from of patients who received mepolizumab for relapsing ICEP was approved by our ethical committee (study PNEU-ILD-02, approval number 2018/15MAR/116).

Informed Consent

As this was a retrospective study, signed informed consent from patients was waived, according to local regulation.

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Brenard, E., Pilette, C., Dahlqvist, C. et al. Real-Life Study of Mepolizumab in Idiopathic Chronic Eosinophilic Pneumonia. Lung (2020). https://doi.org/10.1007/s00408-020-00336-3

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Keywords

  • Idiopathic chronic eosinophilic pneumonia
  • Mepolizumab
  • Interstitial lung diseases