MedPath

Effects of Anti-IL5 Biological Treatments on Blood IgE Levels in Severe Asthmatic Patients

Completed
Conditions
Asthma; Eosinophilic
Asthma
Interventions
Diagnostic Test: Total IgE
Diagnostic Test: Blood cell counts
Diagnostic Test: Asthma control assessment
Diagnostic Test: lung function tests
Registration Number
NCT04181190
Lead Sponsor
Università degli Studi di Ferrara
Brief Summary

Real-life, observational, retrospective, multicenter study to evaluate the effects of anti-IL5 biological treatments on blood total IgE Levels in atopic patients with severe eosinophilic asthma.

Detailed Description

Severe asthma, i.e. asthma that is not controlled despite maximal optimized therapy and/or that worsens when high dose treatment is decreased (GINA guidelines - available at https://ginasthma.or), is a major unmet medical need. Major advances in the management of severe asthma occurred in the past few years due to the new targeted biological therapies. Mepolizumab and Benralizumab are humanized monoclonal antibodies able to block interleukin (IL)-5 and the receptor for IL-5, respectively. These biological treatments block the eosinophilic driven inflammation. The effects of these treatments on an other key effector molecule of the T2-immune response, i.e. IgE, is virtually unknown.

To explore this issue, we set up a real life, observational, retrospective, multicenter study. The study will enroll patients with severe eosinophilic asthma already treated with Mepolizumab or Benralizumab. The following variable will be collected before the the biological treatment and at 4±2 months after the initiation of the pharmacological regimen:

* demographic data

* age of onset of asthma

* smoking habit

* concomitant pharmacological regimens

* number of asthma exacerbations since last visit

* concomitant diseases (particularly gastroesophageal reflux, nasal polyposis, atopic dermatitis, obesity, anxiety-depressive syndrome).

* White Blood Cell Count and Differential (and in particular the levels of total leucocytes, lymphocytes, eosinophils and basophils)

* Lung function tests (spirometry)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
130
Inclusion Criteria
  • atopy
  • severe eosinophilic asthma (according to GINA guideline - available at https://ginasthma.org)
  • patients treated with monoclonal antibody anti IL-5 (Mepolizumab) or with IL-5 anti-receptor monoclonal antibody (Benralizumab).
  • stable asthma (free from asthma exacerbation for at least 8 weeks)
Exclusion Criteria
  • asthma exacerbation in last 8 weeks
  • patients treated for COPD

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Mepolizumab grouplung function testsatopic patients with severe eosinophilic asthma treated with anti-IL-5 monoclonal antibody (Mepolizumab)
Mepolizumab groupBlood cell countsatopic patients with severe eosinophilic asthma treated with anti-IL-5 monoclonal antibody (Mepolizumab)
Benralizumab groupTotal IgEatopic patients with severe eosinophilic asthma treated with anti-IL5 receptor monoclonal antibody (Benralizumab)
Benralizumab groupBlood cell countsatopic patients with severe eosinophilic asthma treated with anti-IL5 receptor monoclonal antibody (Benralizumab)
Mepolizumab groupTotal IgEatopic patients with severe eosinophilic asthma treated with anti-IL-5 monoclonal antibody (Mepolizumab)
Mepolizumab groupAsthma control assessmentatopic patients with severe eosinophilic asthma treated with anti-IL-5 monoclonal antibody (Mepolizumab)
Benralizumab groupAsthma control assessmentatopic patients with severe eosinophilic asthma treated with anti-IL5 receptor monoclonal antibody (Benralizumab)
Benralizumab grouplung function testsatopic patients with severe eosinophilic asthma treated with anti-IL5 receptor monoclonal antibody (Benralizumab)
Primary Outcome Measures
NameTimeMethod
IgE levels in mepolizumab group4±2 months

To evaluate total IgE levels (kU/l) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months after initiation of anti-IL5 monoclonal antibody Mepolizumab

Secondary Outcome Measures
NameTimeMethod
Total leucocytes in mepolizumab group4±2 months

To evaluate total leucocytes (number of cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

Eosinophils (number) in mepolizumab group4±2 months

To evaluate the number of blood eosinophils (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

Eosinophils (%) in mepolizumab group4±2 months

To evaluate the percentage of blood eosinophils (%) total blood white cells in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

Basophils (number) in mepolizumab group4±2 months

To evaluate the number of blood basophils (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

Basophils (%) in mepolizumab group4±2 months

To evaluate the percentage of blood basophils (%) to totale white blood cells in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

lymphocytes (number) in mepolizumab group4±2 months

To evaluate the number of blood lymphocytes (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

Lymphocytes (%) in mepolizumab group4±2 months

To evaluate the percentage of blood lymphocytes (%) to total white cells in atopic patients with severe eosinophilic asthma at 4 ± 2 months from the start of treatment with anti-IL5 monoclonal antibody Mepolizumab

IgE levels in Benralizumab group4±2 months

To evaluate total IgE levels (kU/l) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Total leucocytes in Benralizumab group4±2 months

To evaluate total leucocytes (number of cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab compared to the pretreatment value

Eosinophils (number) in Benralizumab group4±2 months

To evaluate the number of blood eosinophils (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Eosinophils (%) in Benralizumab group4±2 months

To evaluate the percentage of blood eosinophils (%) total blood white cells in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Basophils (number) in Benralizumab group4±2 months

To evaluate the number of blood basophils (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Basophils (%) in Benralizumab group4±2 months

To evaluate the percentage of blood basophils (%) to totale white blood cells in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Lymphocytes (number) in Benralizumab group4±2 months

To evaluate the number of blood lymphocytes (cell/µl) in atopic patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benralizumab

Lymphocites (%) in Benralizumab group4±2 months

To evaluate the percentage of blood lymphocytes (%) to total white cells in atopic patients with severe eosinophilic asthma at 4 ± 2 months from the start of treatment with Benralizumab

respiratory function (FEV1 - liter) in Mepolizumab group4±2 months

To evaluate FEV1 (liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (FEV1 - %) in Mepolizumab group4±2 months

To evaluate FEV1 (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (vital capacity - liter) in Mepolizumab group4±2 months

To evaluate vital capacity (VC - liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (vital capacity - %) in Mepolizumab group4±2 months

To evaluate VC (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (forced vital capacity - liter) in Mepolizumab group4±2 months

To evaluate forced vital capacity (FVC - liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (forced vital capacity - % predicted) in Mepolizumab group4±2 months

To evaluate FVC (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (FEV1/FVC ratio) in Mepolizumab group4±2 months

To evaluate FEV1/FVC ratio in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab compared to the pretreatment value.

respiratory function (FEV1/VC ratio) in Mepolizumab group4±2 months

To evaluate FEV1/VC ratio in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

respiratory function (FEV1 - %) in Benralizumab group4±2 months

To evaluate FEV1 (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (FEV1 - lier) in Benralizumab group4±2 months

To evaluate FEV1 (liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (FVC - liter) in Benralizumab group4±2 months

To evaluate FVC (liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (FVC - %) in Benralizumab group4±2 months

To evaluate FVC (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (VC - liter) in Benralizumab group4±2 months

To evaluate VC (liter) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (VC - %) in Benralizumab group4±2 months

To evaluate VC (% predicted) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

respiratory function (FEV1/FVC ratio) in Benralizumab group4±2 months

To evaluate FEV1/VC ratio in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab compared to the pretreatment value.

respiratory function (FEV1/VC ratio) in Benralizumab group4±2 months

To evaluate FEV1/FVC ratio in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

Fractional exhaled nitric oxigen (FeNO) in Mepozumab group4±2 months

To evaluate FeNO (ppb) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Mepolizumab

Fractional exhaled nitric oxigen (FeNO) in Benralizumab group4±2 months

To evaluate FeNO (ppb) in patients with severe eosinophilic asthma at baseline and at 4 ± 2 months from the start of treatment with Benraluzumab

Asthma control test in Mepolizumab group4±2 months

To evaluate asthma control test (ACT) in patients with severe eosinophilic asthma at baseline and at baseline and at 4 ± 2 months from the start of Mepolizumab

Asthma control test in Benralizumab group4±2 months

To evaluate asthma control test (ACT) in patients with severe eosinophilic asthma at baseline and at baseline and at 4 ± 2 months from the start of Benralizumab

correlation between eosinophils and total IgE4±2 months

To evaluate the correlations (Pearson correlation coefficient) between the change in total eosinophil counts and IgE levels in patients treated with Mepolizumab or Benralizumab.

correlation between total IgE and lung function4±2 months

To evaluate the correlations (Pearson correlation coefficient) between the change in total IgE levels and in functional parameters (FEV1, FVC and VC) in patients treated with Mepolizumab or Benralizumab.

correlation between total IgE and asthma control4±2 months

To evaluate the correlations (Pearson correlation coefficient) between the change in total IgE levels and the change of asthma control (measured by asthma control test - ACT) in patients treated with Mepolizumab or Benralizumab.

Trial Locations

Locations (8)

Azienda Ospedaliero Universitaria Ferrara

🇮🇹

Ferrara, Italy

Professor of Respiratory Medicine Department of Medical and Surgical Sciences University of Foggia - Italy

🇮🇹

Foggia, Italy

Malattie dell' Apparato Respiratorio Dipartimento di Scienza Mediche e Chirurgiche Materni-Infantili e dell'Adulto. Azienda Ospedaliero Universitaria di Modena

🇮🇹

Modena, Italy

UOC Pneumologia Azienda Ospedaliera Univeristaria Integrata - Verona

🇮🇹

Verona, Italy

UOC Pneumologia Ospedale L.Sacco - Polo Univestiario ASST Fatebenefratelli - Milano

🇮🇹

Milan, Italy

AOUP Giaccone Palermo, dipartimento PROMISE, Università di Palermo

🇮🇹

Palermo, Italy

S.C di Pneumologia Ospedale S. Maria degli Angeli AAS5 Friuli Occidentale

🇮🇹

Pordenone, Italy

Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia-IRCCS

🇮🇹

Reggio Emilia, Italy

© Copyright 2025. All Rights Reserved by MedPath