Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases
The indications for biologic therapy are expanding. Patients may benefit from different biologics for separate conditions or one condition with multiple pathogenic mechanisms targeted by different biologics. We sought to determine the frequency and safety of combining biologics targeting IgE, IL-5,...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | World Allergy Organization Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455122000837 |
| _version_ | 1811320614187696128 |
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| author | Mitchell M. Pitlick, MD Thanai Pongdee, MD |
| author_facet | Mitchell M. Pitlick, MD Thanai Pongdee, MD |
| author_sort | Mitchell M. Pitlick, MD |
| collection | DOAJ |
| description | The indications for biologic therapy are expanding. Patients may benefit from different biologics for separate conditions or one condition with multiple pathogenic mechanisms targeted by different biologics. We sought to determine the frequency and safety of combining biologics targeting IgE, IL-5, IL-5R, and IL-4/IL-13 in patients referred to a large academic health system through retrospective chart review. Between January 1, 2015 and July 31, 2021, 25 patients receiving multiple biologics simultaneously were identified. Combinations included omalizumab + mepolizumab (n = 11), omalizumab + dupilumab (n = 6), omalizumab + benralizumab (n = 4), mepolizumab + dupilumab (n = 3), and omalizumab + dupilumab + mepolizumab (n = 1). Sixteen patients were receiving multiple biologics for the same condition, most commonly asthma (n = 10). Nine patients were treated for separate conditions, with chronic spontaneous urticaria and atopic dermatitis being the most common combination (n = 3). The median duration of combination biologic use was 17.5 months. There were no reports of anaphylaxis, other allergic reaction, immune dysfunction, pneumonia, or development of malignancy. The use of multiple biologics appears to be well tolerated in this case series. Prospective study is needed to better determine the efficacy, safety, and cost-effectiveness of this approach. |
| first_indexed | 2024-04-13T13:02:22Z |
| format | Article |
| id | doaj.art-dcb084c90bd44ae89c4c1ba09a1b914f |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-04-13T13:02:22Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-dcb084c90bd44ae89c4c1ba09a1b914f2022-12-22T02:45:53ZengElsevierWorld Allergy Organization Journal1939-45512022-11-011511100707Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory DiseasesMitchell M. Pitlick, MD0Thanai Pongdee, MD1Corresponding author. Mitchell Pitlick, MD Mayo Clinic, Division of Allergic Diseases, 200 First Street SW, Rochester, MN, 55905, USA; Division of Allergic Diseases, Mayo Clinic, Rochester, MN, USADivision of Allergic Diseases, Mayo Clinic, Rochester, MN, USAThe indications for biologic therapy are expanding. Patients may benefit from different biologics for separate conditions or one condition with multiple pathogenic mechanisms targeted by different biologics. We sought to determine the frequency and safety of combining biologics targeting IgE, IL-5, IL-5R, and IL-4/IL-13 in patients referred to a large academic health system through retrospective chart review. Between January 1, 2015 and July 31, 2021, 25 patients receiving multiple biologics simultaneously were identified. Combinations included omalizumab + mepolizumab (n = 11), omalizumab + dupilumab (n = 6), omalizumab + benralizumab (n = 4), mepolizumab + dupilumab (n = 3), and omalizumab + dupilumab + mepolizumab (n = 1). Sixteen patients were receiving multiple biologics for the same condition, most commonly asthma (n = 10). Nine patients were treated for separate conditions, with chronic spontaneous urticaria and atopic dermatitis being the most common combination (n = 3). The median duration of combination biologic use was 17.5 months. There were no reports of anaphylaxis, other allergic reaction, immune dysfunction, pneumonia, or development of malignancy. The use of multiple biologics appears to be well tolerated in this case series. Prospective study is needed to better determine the efficacy, safety, and cost-effectiveness of this approach.http://www.sciencedirect.com/science/article/pii/S1939455122000837BiologicEosinophilsOmalizumabBenralizumabMepolizumabDupilumab |
| spellingShingle | Mitchell M. Pitlick, MD Thanai Pongdee, MD Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases World Allergy Organization Journal Biologic Eosinophils Omalizumab Benralizumab Mepolizumab Dupilumab |
| title | Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases |
| title_full | Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases |
| title_fullStr | Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases |
| title_full_unstemmed | Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases |
| title_short | Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases |
| title_sort | combining biologics targeting eosinophils il 5 il 5r ige and il 4 il 13 in allergic and inflammatory diseases |
| topic | Biologic Eosinophils Omalizumab Benralizumab Mepolizumab Dupilumab |
| url | http://www.sciencedirect.com/science/article/pii/S1939455122000837 |
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