“For the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) a very particular and important drug is now available. It is called mepolizumab and it is the first targeted treatment approved for EGPA. It is an intelligent biological drug that blocks a substance called interleukin 5 (Il-5), which has a central role in the disease. In fact, Il-5 is the most important cytokine for eosinophils because it increases their survival the number of eosinophils, the cells responsible for the tissue damage typical of EGPA”. Alessandra Vultaggio, researcher in the department of Experimental and Clinical Medicine at the University of Florence, Sod Immunoallergologia Aou Careggi, said this to Adnkronos Salute on the occasion of the Siaaic congress, the Italian Society of Allergology, Asthma and Clinical Immunology, which took place is held in Rome.
EGPA, formerly known as Churg-Strauss syndrome, is a complex disease that affects various organs such as the kidneys, nerves, heart, skin and blood vessels. “Patients treated with mepolizumab – explains the expert – can go into remission, that is, achieve a disappearance of the signs and symptoms that the disease entails, allowing them to greatly reduce, even suspending, the amount of cortisone taken daily. Let’s talk of an inflammatory disease characterized by an increase in eosinophils in the blood, a particular type of white blood cell, and a consequent increase in these cells in the various tissues where they cause structural damage. Almost all patients experience asthma and nasal polyposis, a which are then associated with various signs and symptoms linked to the type of organ involved”.
Mepolizumab is proving to be safe and effective even in longer-lasting and more severe forms of disease, preventing relapses. “For some years now the drug has been part of our pharmaceutical armamentarium – continues Vultaggio – In Italy, first with severe asthmatic patients and now also for other diseases such as nasal polyposis, hypereosinophilic syndrome and EGPA, we are observing even better therapeutic successes than those of the registration trials”. These results lead to implementing the diagnosis as quickly as possible, so as to be able to promptly evaluate the introduction of the biological drug.
“Often the history of patients with Egpa is a long one – underlines the expert – characterized by considerable diagnostic delay. It is important to know the disease and know how to suspect it. Simple blood tests that record the marked increase in eosinophils in the blood in patients help us with a history of asthma and nasal polyposis and, sometimes, also the positivity of some particular autoantibodies in the blood, called Anca”.
Since it is a pathology that can affect different organs, the clinical manifestations of EGPA are heterogeneous and therefore different specialists may be faced with patients in whom the pathology is suspected. “We allergists and immunologists – adds Vultaggio – need to collaborate in a multidisciplinary team which includes pulmonologists, ENT specialists, cardiologists, nephrologists, radiologists and anatomic pathologists”. The exchange of information and skills between the various specialists, in fact, “is essential to reach the diagnosis earlier and to optimize the treatment – concludes the specialist – until the introduction of the biological drug and the monitoring of its therapeutic effects”.
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