1
|
Dupin C, Valéry S, Guilleminault L, Devouassoux G, Merveilleau M, Russier M, Mourin G, Pradelli J, Bonniaud P, Le Brun M, Ebstein E, Juge PA, Lillo-Lelouet A, Taillé C. Articular manifestations related to anti-interleukin-5 therapies in severe asthma: a case series. ERJ Open Res 2024; 10:00935-2023. [PMID: 38410709 PMCID: PMC10895420 DOI: 10.1183/23120541.00935-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/15/2023] [Indexed: 02/28/2024] Open
Abstract
Articular manifestations should be screened before and during anti-IL-5/5R biologic treatment in severe asthma. Rigorous multidisciplinary team discussion should be carried out to assess the risk-benefit balance of withholding effective treatment. https://bit.ly/3vfPn4k.
Collapse
Affiliation(s)
- Clairelyne Dupin
- Service de Pneumologie et Centre de référence pour les maladies respiratoires rares, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
- CRISALIS F-CRIN network, Paris, France
- C. Dupin and S. Valéry contributed equally to the submitted work
| | - Solène Valéry
- Service de Pneumologie et Centre de référence pour les maladies respiratoires rares, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
- C. Dupin and S. Valéry contributed equally to the submitted work
| | - Laurent Guilleminault
- CRISALIS F-CRIN network, Paris, France
- Service de Pneumologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291 – CNRS UMR5051 – Université Toulouse III, Toulouse, France
| | - Gilles Devouassoux
- CRISALIS F-CRIN network, Paris, France
- Service de Pneumologie, Hôpital de la Croix Rousse, Lyon, France
| | | | - Maud Russier
- Cabinet de Pneumologie, Maison Médicale du Larry, Olivet, France
| | | | - Johana Pradelli
- Service de Pneumologie-Allergologie, CHU de Nice, Nice, France
| | - Philippe Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoires, CHU Dijon-Bourgogne, Dijon, France
| | - Mathilde Le Brun
- Service de Pneumologie et Centre de référence pour les maladies respiratoires rares, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
- CRISALIS F-CRIN network, Paris, France
| | - Esther Ebstein
- Service de Rhumatologie, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
| | - Pierre-Antoine Juge
- Service de Rhumatologie, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
| | - Agnès Lillo-Lelouet
- Centre Régional de Pharmacovigilance de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Camille Taillé
- Service de Pneumologie et Centre de référence pour les maladies respiratoires rares, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
- CRISALIS F-CRIN network, Paris, France
| |
Collapse
|
2
|
Pera V, Brusselle GG, Riemann S, Kors JA, Van Mulligen EM, Parry R, de Wilde M, Rijnbeek PR, Verhamme KMC. Parasitic infections related to anti-type 2 immunity monoclonal antibodies: a disproportionality analysis in the food and drug administration's adverse event reporting system (FAERS). Front Pharmacol 2023; 14:1276340. [PMID: 38035014 PMCID: PMC10682182 DOI: 10.3389/fphar.2023.1276340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction: Monoclonal antibodies (mAbs) targeting immunoglobulin E (IgE) [omalizumab], type 2 (T2) cytokine interleukin (IL) 5 [mepolizumab, reslizumab], IL-4 Receptor (R) α [dupilumab], and IL-5R [benralizumab]), improve quality of life in patients with T2-driven inflammatory diseases. However, there is a concern for an increased risk of helminth infections. The aim was to explore safety signals of parasitic infections for omalizumab, mepolizumab, reslizumab, dupilumab, and benralizumab. Methods: Spontaneous reports were used from the Food and Drug Administration's Adverse Event Reporting System (FAERS) database from 2004 to 2021. Parasitic infections were defined as any type of parasitic infection term obtained from the Standardised Medical Dictionary for Regulatory Activities® (MedDRA®). Safety signal strength was assessed by the Reporting Odds Ratio (ROR). Results: 15,502,908 reports were eligible for analysis. Amongst 175,888 reports for omalizumab, mepolizumab, reslizumab, dupilumab, and benralizumab, there were 79 reports on parasitic infections. Median age was 55 years (interquartile range 24-63 years) and 59.5% were female. Indications were known in 26 (32.9%) reports; 14 (53.8%) biologicals were reportedly prescribed for asthma, 8 (30.7%) for various types of dermatitis, and 2 (7.6%) for urticaria. A safety signal was observed for each biological, except for reslizumab (due to lack of power), with the strongest signal attributed to benralizumab (ROR = 15.7, 95% Confidence Interval: 8.4-29.3). Conclusion: Parasitic infections were disproportionately reported for mAbs targeting IgE, T2 cytokines, or T2 cytokine receptors. While the number of adverse event reports on parasitic infections in the database was relatively low, resulting safety signals were disproportionate and warrant further investigation.
Collapse
Affiliation(s)
- Victor Pera
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Guy G. Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Departments of Epidemiology and Respiratory Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sebastian Riemann
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan A. Kors
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Erik M. Van Mulligen
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rowan Parry
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marcel de Wilde
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter R. Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Katia M. C. Verhamme
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| |
Collapse
|
3
|
Safety of Non-Steroidal Anti-Inflammatory Drugs in the Elderly: An Analysis of Published Literature and Reports Sent to the Portuguese Pharmacovigilance System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063541. [PMID: 35329224 PMCID: PMC8949212 DOI: 10.3390/ijerph19063541] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently used agents to treat musculoskeletal disorders (principally by the elderly), thus raising the risk of adverse drug reactions (ADRs). This work aims to monitor NSAIDs safety profile in older people by using literature and pharmacovigilance data. Published clinical studies reporting the NSAIDs safety in elderly patients (age ≥ 65) were identified by a literature search and were then deeply analyzed. In addition, suspected ADRs reports submitted to the Portuguese Pharmacovigilance System (PPS) involving patients aged ≥65 with at least one NSAID as suspected drug were explored in detail. Most studies concluded that the risk of gastrointestinal, cardiovascular, and renal ADRs was significantly lower with cyclooxygenase-2 (COX-2)-selective NSAIDs use than with nonselective NSAIDs. The PPS data analysis showed that serious gastrointestinal ADRs occurred mostly in patients taking more than one NSAID and/or another concomitant drug that increases the incidence of these events, in the absence of gastroprotection. The results suggest that while NSAID toxicity is well understood, their safe use needs to be monitored in clinical practice. Furthermore, the pharmacovigilance data analyzed also showed that monitoring NSAIDs use in elderly remains essential to mitigate the associated risks, especially in those with comorbidities and under polytherapy.
Collapse
|
4
|
Omalizumab: An Optimal Choice for Patients with Severe Allergic Asthma. J Pers Med 2022; 12:jpm12020165. [PMID: 35207654 PMCID: PMC8878072 DOI: 10.3390/jpm12020165] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/28/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022] Open
Abstract
Omalizumab is the first monoclonal antibody that was globally approved as a personalized treatment option for patients with moderate-to-severe allergic asthma. This review summarizes the knowledge of almost two decades of use of omalizumab to answer some important everyday clinical practice questions, concerning its efficacy and safety and its association with other asthma-related and drug-related parameters. Evidence suggests that omalizumab improves asthma control and reduces the incidence and frequency of exacerbations in patients with severe allergic asthma. Omalizumab is also effective in those patients in reducing corticosteroid use and healthcare utilization, while it also seems to improve lung function. Several biomarkers have been recognized in predicting its efficacy in its target group of patients, while the optimal duration for evaluating its efficacy is between 16 and 32 weeks.
Collapse
|
5
|
Israel E, Canonica GW, Brusselle G, Yang S, Howarth PH, Martin AL, Koufopoulou M, Smith SG, Alfonso-Cristancho R. Real-life effectiveness of mepolizumab in severe asthma: a systematic literature review. J Asthma 2021; 59:2201-2217. [PMID: 34951336 DOI: 10.1080/02770903.2021.2008431] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The efficacy and safety of mepolizumab in patients with severe eosinophilic asthma in randomized controlled trials is well established. Following approval of mepolizumab as add-on therapy for severe eosinophilic asthma in multiple regions worldwide, it is now important to determine its impact in real-world settings in which patients are not subject to stringent eligibility criteria. This systematic literature review assessed published evidence of clinical outcomes, safety, and healthcare resource use among patients with severe asthma receiving mepolizumab in real-world settings. DATA SOURCES Searches were conducted in Embase, MEDLINE, and MEDLINE In-Process via Ovid. STUDY SELECTIONS Eligible studies were observational, and enrolled ≥10 patients with asthma who received mepolizumab 100 mg subcutaneously. Data extracted included annualized exacerbation rate, mean daily oral corticosteroid (OCS) dose, proportion of patients using OCS, several measures of lung function, patient-reported asthma control and health-related quality of life (HRQoL), safety, and economic burden. RESULTS Twenty-three articles (22 unique studies; 2,040 patients with severe asthma on mepolizumab) were identified. Mepolizumab use was associated with a reduction in annualized exacerbation rates (requiring OCS) of 54-97% (p < 0.05 in all studies), reduced mean/median daily OCS doses, and OCS discontinuation during follow-up (27-84% of patients). Improvements in lung function, asthma control, and HRQoL were also observed. The most commonly reported adverse events included headache and arthralgia; discontinuation of mepolizumab due to adverse events occurred in 0-10.6% of patients. CONCLUSION Findings show that patients with severe asthma consistently demonstrate clinically relevant benefits with mepolizumab treatment in a real-world setting. Supplemental data for this article is available online at at www.tandfonline.com/ijas .
Collapse
Affiliation(s)
- Elliot Israel
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Giorgio Walter Canonica
- Personalized Medicine Asthma and Allergy Clinic, Department of Biomedical Sciences, Humanitas University and Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Shibing Yang
- Value Evidence and Outcomes, GSK, Collegeville, PA, USA
| | | | - Amber L Martin
- Evidence Synthesis, Modeling & Communication, Evidera, Waltham, MA, USA
| | | | - Steven G Smith
- Respiratory Therapeutic Area, GSK, Research Triangle Park, NC, USA
| | | |
Collapse
|
6
|
Monteiro C, Silvestre S, Duarte AP, Alves G. Assessment of suspected adverse drug reactions in elderly patients with diabetes mellitus based on a Portuguese spontaneous reporting database: analysis of reporting from 2008 to 2018. Expert Opin Drug Saf 2021; 20:845-853. [PMID: 33962523 DOI: 10.1080/14740338.2021.1928072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Age is one of the most important risk factors in the development of diabetes mellitus and certain drug classes indicated for this condition may be associated with clinically important adverse drug reactions (ADRs). The aim of this study was to analyze the suspected ADRs in older patients with diabetes mellitus, reported to the Portuguese Pharmacovigilance System from 2008 to 2018. RESEARCH DESIGN AND METHODS A retrospective analysis of suspected ADRs reports was performed, involving patients aged ≥65 years. RESULTS Of a total of 751 reports collected, 439 were considered serious, 199 led to hospitalization and in 19 of them occurred a fatal outcome. Most of them were observed in females (n = 393) and involved patients belonging mainly to the age group 65-74 years (n = 405). Taking into account a total of 2134 suspected ADRs, the most frequent were hypoglycemia (2.67%) and lactic acidosis (2.62%). The drugs specifically indicated for glycemic control were the most frequently involved in ADRs. CONCLUSIONS Most of the ADRs were reported as serious and were mainly associated to drugs in diabetes mellitus. In addition, the majority of them, such as hypoglycemia, are preventable, highlighting the importance to identify possible factors that determine this occurrence, especially in the elderly.
Collapse
Affiliation(s)
- Cristina Monteiro
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal
| | - Samuel Silvestre
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Ana Paula Duarte
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal.,CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Gilberto Alves
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal.,CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,ESALD-IPCB - Dr. Lopes Dias School of Health, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| |
Collapse
|
7
|
Adverse drug reactions associated with the use of biological agents. PLoS One 2020; 15:e0240276. [PMID: 33338057 PMCID: PMC7748267 DOI: 10.1371/journal.pone.0240276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/24/2020] [Indexed: 12/27/2022] Open
Abstract
Introduction Biological drugs open new possibilities to treat diseases for which drug therapy is limited, but they may be associated with adverse drug reactions (ADRs). Objective To identify the ADRs associated with the use of biological drugs in Colombia. Methods This was a retrospective study of ADR reports from 2014 to 2019, contained in the database of Audifarma SA pharmacovigilance program. The ADRs, groups of associated drugs, and affected organs were classified. Results In total, 5,415 reports of ADRs associated with biological drugs were identified in 78 Colombian cities. A total of 76.1% of the cases corresponded to women. The majority were classified as type A (55.0%) and B (28.9%), and 16.7% were serious cases. The respiratory tract was the most affected organ system (16.8%), followed by the skin and appendages (15.6%). Antineoplastic and immunomodulatory drugs accounted for 70.6% of the reports, and the drugs related to the greatest number of ADRs were adalimumab (12.2%) and etanercept (11.6%). Conclusions The reporting of ADRs has increased in recent years and these reactions are mostly classified as tyoe A or B, categorized as serious in almost one-fifth of the reported cases and associated mainly with immunomodulators and antineoplastic agents. This type of study can support decision makers in ways that benefit patient safety and interaction with health systems.
Collapse
|