mepolizumab治疗嗜酸性肉芽肿病合并多血管炎的证据:一项范围审查

Eduardo Tuta-Quintero , Isabella Perna-Reyes , Juan Olivella-Gómeza , Daniela Rodríguez-Fraile , Juan C. Santacruz , Andrea A. Mayorga-Borja , John Londoño
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摘要

Mepolizumab (MPZ)是嗜酸性肉芽肿病合并多血管炎(EGPA)的治疗选择。然而,关于其功效、有效性和安全性的证据是有限的。我们的研究结果包括17篇评估MPZ在诊断为EGPA的患者中的应用的全文文章,其中47%(8/17)为病例报告,18%(3/17)为回顾性队列研究,12%(2/17)为临床试验,6%对应于前瞻性队列(1/17)、双视角队列(1/17)、病例系列(1/17)和试点研究(1/17)。在纳入的文献中,59%(10/17)的文献描述了MPZ最常用的剂量为300 mg/月。伯明翰血管炎活动度评分的降低、皮质类固醇剂量的减少和血液中嗜酸性粒细胞数量的调节是决定患者临床效果的最常用变量。最后,纳入了10项临床试验记录,描述了正在进行的研究的设计、实施和管理。在EGPA患者中使用MPZ可降低伯明翰血管炎活动评分,节省口服皮质类固醇并调节血液嗜酸性粒细胞增多症。在所有纳入的研究中,描述的不良事件为轻度和中度。
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Therapeutic evidence of mepolizumab in eosinophilic granulomatosis with polyangiitis: A scoping review
Mepolizumab (MPZ) is a therapeutic option for eosinophilic granulomatosis with polyangiitis (EGPA). However, the evidence on its efficacy, effectiveness, and safety is limited. Our results included 17 full-text articles evaluating the use of MPZ in patients diagnosed with EGPA, 47% (8/17) of the documents were case reports, 18% (3/17) retrospective cohort studies, 12% (2/17) clinical trials, and 6% corresponded to a prospective cohort (1/17), ambispective cohort (1/17), case series (1/17), and pilot study (1/17). The most frequently used dose of MPZ was 300 mg/month, described in 59% (10/17) of the included manuscripts. The decrease in the Birmingham Vasculitis Activity Score, reduction in the dose of corticosteroids, and modulation in the number of eosinophils in the blood were the variables most used to determine the clinical effect in patients. Finally, 10 clinical trial records were included describing the design, conduct, and administration of the ongoing studies. The use of MPZ in patients with EGPA shows a reduction in the Birmingham Vasculitis Activity Score, saving oral corticosteroids and modulating blood hypereosinophilia. The adverse events described were mild and moderate in all the included studies.
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