When the effectiveness of mepolizumab decreases, patients with severe asthma may benefit from benralizumab. Researchers conclude this on the basis of a small-scale observational cohortstudie.
At 6 months after starting mepolizumab, all patients (n = 68) had an optimal response to mepolizumab. Of these, 30 were switched to benralizumab after a median of 21 months from starting mepolizumab. Conversion occurred relatively more often in patients with a lower age, higher dose of oral corticosteroids and/or lower eosinophil concentrations.
At the time of conversion, the number of exacerbations had increased from 0 to 1 to 4 to 6 per year. At follow-up (median 31 months from start of mepolizumab) this had fallen again to 0 to 2 per year.
According to the NVALT Guideline Diagnosis and Treatment of Severe Asthma (2020), the 3 available IL-5 inhibitors are not interchangeable. This study shows that switching to another IL-5 inhibitor can be effective in certain patients due to decreasing effect in practice. Further research should show whether this is generally the case.
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Bron:
Responsible Medicine Use Institute
2023-08-11 10:06:27
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