Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis
We aimed to evaluate the efficacy and safety of mepolizumab (MEP) in the management of hypereosinophilic syndrome (HES). A systematic search was performed, and articles published until March 2021 were analyzed. The primary efficacy results evaluated were hospitalization rate related to HES, morbidit...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2021-10-01
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| Series: | Clinics |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100427&tlng=en |
| _version_ | 1818245192164048896 |
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| author | José Mario Alves Júnior Francisco Eduardo Prota Danilo Villagelin Fernanda Bley Wanderley Marques Bernardo |
| author_facet | José Mario Alves Júnior Francisco Eduardo Prota Danilo Villagelin Fernanda Bley Wanderley Marques Bernardo |
| author_sort | José Mario Alves Júnior |
| collection | DOAJ |
| description | We aimed to evaluate the efficacy and safety of mepolizumab (MEP) in the management of hypereosinophilic syndrome (HES). A systematic search was performed, and articles published until March 2021 were analyzed. The primary efficacy results evaluated were hospitalization rate related to HES, morbidity (new or worsening), relapses/failure, treatment-related adverse effects, prednisone dosage ≤10 mg/day for ≥8 weeks, and eosinophil count <600/μL for ≥8 weeks. A meta-analysis was conducted, when appropriate. Three randomized controlled trials (RCTs), with a total of 255 patients, were included. The studies contemplated the use of MEP 300 mg/SC or 750 mg/IV. According to the evaluation of the proposed outcomes, when relapse rates/therapeutic failures were assessed, there was a 26% reduction with MEP 300 mg/SC (RD=-0.26; 95% CI: -0.44 to -0.08; p=0.04) and 48% reduction with MEP 750 mg/IV (RD=-0.48; 95% CI: -0.67, -0.30; p<0.00001). For the outcomes, prednisone dosage ≤10 mg/day for ≥8 weeks was 48% (RD=0.48; 95% CI: 0.35 to 0.62; p<0.00001), and the eosinophil count <600/μL for ≥8 weeks was 51% (RD=0.51; 95% CI: 0.38 to 0.63; p<0.00001), both showed a reduction with MEP 300 mg/IV and 750 mg/IV. No statistically significant differences in treatment-related adverse effects outcomes were observed for either dosage (RD=0.09; 95% CI: -0.05 to 0.24; p=0.20; RD=0.09; 95% CI: -0.11 to 0.29; p=0.39). Despite the positive effects observed for the studied outcomes, the exact significance remains unclear. |
| first_indexed | 2024-12-12T14:29:00Z |
| format | Article |
| id | doaj.art-3b37391bf05a4a62b0615874db9163fb |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T14:29:00Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-3b37391bf05a4a62b0615874db9163fb2022-12-22T00:21:36ZengElsevier EspañaClinics1980-53222021-10-017610.6061/clinics/2021/e3271Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysisJosé Mario Alves Júniorhttps://orcid.org/0000-0002-3286-8619Francisco Eduardo Protahttps://orcid.org/0000-0003-1843-5240Danilo Villagelinhttps://orcid.org/0000-0002-4173-7258Fernanda Bleyhttps://orcid.org/0000-0003-4163-9778Wanderley Marques Bernardohttps://orcid.org/0000-0002-8597-5207We aimed to evaluate the efficacy and safety of mepolizumab (MEP) in the management of hypereosinophilic syndrome (HES). A systematic search was performed, and articles published until March 2021 were analyzed. The primary efficacy results evaluated were hospitalization rate related to HES, morbidity (new or worsening), relapses/failure, treatment-related adverse effects, prednisone dosage ≤10 mg/day for ≥8 weeks, and eosinophil count <600/μL for ≥8 weeks. A meta-analysis was conducted, when appropriate. Three randomized controlled trials (RCTs), with a total of 255 patients, were included. The studies contemplated the use of MEP 300 mg/SC or 750 mg/IV. According to the evaluation of the proposed outcomes, when relapse rates/therapeutic failures were assessed, there was a 26% reduction with MEP 300 mg/SC (RD=-0.26; 95% CI: -0.44 to -0.08; p=0.04) and 48% reduction with MEP 750 mg/IV (RD=-0.48; 95% CI: -0.67, -0.30; p<0.00001). For the outcomes, prednisone dosage ≤10 mg/day for ≥8 weeks was 48% (RD=0.48; 95% CI: 0.35 to 0.62; p<0.00001), and the eosinophil count <600/μL for ≥8 weeks was 51% (RD=0.51; 95% CI: 0.38 to 0.63; p<0.00001), both showed a reduction with MEP 300 mg/IV and 750 mg/IV. No statistically significant differences in treatment-related adverse effects outcomes were observed for either dosage (RD=0.09; 95% CI: -0.05 to 0.24; p=0.20; RD=0.09; 95% CI: -0.11 to 0.29; p=0.39). Despite the positive effects observed for the studied outcomes, the exact significance remains unclear.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100427&tlng=enMepolizumabHumanized Monoclonal AntibodyHypereosinophilic Syndrome |
| spellingShingle | José Mario Alves Júnior Francisco Eduardo Prota Danilo Villagelin Fernanda Bley Wanderley Marques Bernardo Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis Clinics Mepolizumab Humanized Monoclonal Antibody Hypereosinophilic Syndrome |
| title | Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis |
| title_full | Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis |
| title_fullStr | Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis |
| title_short | Mepolizumab in Hypereosinophilic Syndrome: A Systematic Review and Meta-analysis |
| title_sort | mepolizumab in hypereosinophilic syndrome a systematic review and meta analysis |
| topic | Mepolizumab Humanized Monoclonal Antibody Hypereosinophilic Syndrome |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100427&tlng=en |
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