“It is a rare autoimmune disease that belongs to the category of vasculitis, that is, diseases that are characterized by inflammation of the blood vessels, in particular small-caliber ones such as arteries and capillaries, which is characterized by the presence in the blood of higher values of eosinophils, a type of white blood cell that should normally be activated in the presence of parasitic infections and allergic responses, is particularly difficult”, but with targeted therapies “against interleukin 5 (Il-5) we are having excellent results”. This is how Edoardo Conticini, PhD student in Translational and Precision Medicine at the University of Siena, Uoc Rheumatology, describes to Adnkronos eosinophilic granulomatosis with polyangiitis (EGPA), to which an event has been dedicated in recent days in Florence training course created with the support of Gsk.
In these patients, Conticini describes, the pathology manifests itself with “asthma, a condition that appears particularly serious, usually on a non-allergic basis and not responsive to classic therapies”. EGPA is then accompanied by “many other manifestations such as pneumonia and nasal polyposis, this too particularly severe – lists the expert – The complications are even more serious: cutaneous vasculitis with manifestations of variable severity, glomerulonephritis at the renal level or problems with neurological level, as well as of the heart, with myocarditis or endocarditis, but also of the gastrointestinal tract, with risk of fulminant enteritis – he underlines – which can also be associated with a high mortality”.
In Italy we can estimate “a presence of around 1,000-1,200 patients – continues Conticini – Since there is no frank familiarity with the disease, the diagnosis is also extremely difficult: patients experience a diagnostic delay which can be many years”, so when they arrive in the specialist’s office they also have behind them “tens of years of illness and the chronic use, to control the symptoms, of oral cortisone, burdened by important side effects, and of immunosuppressants, frankly not very effective”. In recent years “the first biological drug, a specific monoclonal antibody for the treatment of this disease, has been approved and is therefore used – recalls the specialist. It is a drug which is directed against interleukin 5, it is called mepolizumab and It is giving excellent results. Its administration is simple, once every 4 weeks. The prescription is limited to specialists in third level centers. In Tuscany the reference center for EGPA is in Siena, where we have the vasculitis clinic. pulmonary clinics specifically dedicated to these and other conditions, but – he concludes – the center of Pisa and the center of Florence are also active”.
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