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Severe Pediatric Asthma Therapy: Mepolizumab

There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second contr...

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Autores principales: Ullmann, Nicola, Peri, Francesca, Florio, Olivia, Porcaro, Federica, Profeti, Elisa, Onofri, Alessandro, Cutrera, Renato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283570/
https://www.ncbi.nlm.nih.gov/pubmed/35844748
http://dx.doi.org/10.3389/fped.2022.920066
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author Ullmann, Nicola
Peri, Francesca
Florio, Olivia
Porcaro, Federica
Profeti, Elisa
Onofri, Alessandro
Cutrera, Renato
author_facet Ullmann, Nicola
Peri, Francesca
Florio, Olivia
Porcaro, Federica
Profeti, Elisa
Onofri, Alessandro
Cutrera, Renato
author_sort Ullmann, Nicola
collection PubMed
description There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second controller. In this scenario, mepolizumab, a humanized monoclonal antibody, has proven to be effective in controlling eosinophil proliferation by targeting interleukin-5 (IL-5), a key mediator of eosinophil activation pathways. Mepolizumab is approved since 2015 for adults at a monthly dose of 100 mg subcutaneously and it has been approved for patients ≥ 6 years of age in 2019. Especially in children aged 6 to 11 years, mepolizumab showed a greater bioavailability, with comparable pharmacodynamics parameters as in the adult population. The recommended dose of 40 mg every 4 weeks for children aged 6 through 11 years, and 100 mg for patients ≥ 12 years provides appropriate concentration and proved similar therapeutic effects as in the adult study group. A marked reduction in eosinophil counts clinically reflects a significant improvement in asthma control as demonstrated by validated questionnaires, reduction of exacerbation rates, and the number of hospitalizations. Finally, mepolizumab provides a safety and tolerability profile similar to that observed in adults with adverse events mostly of mild or moderate severity. The most common adverse events were headache and injection-site reaction. In conclusion, mepolizumab can be considered a safe and targeted step-up therapy for severe asthma with an eosinophilic phenotype in children and adolescents.
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spelling pubmed-92835702022-07-16 Severe Pediatric Asthma Therapy: Mepolizumab Ullmann, Nicola Peri, Francesca Florio, Olivia Porcaro, Federica Profeti, Elisa Onofri, Alessandro Cutrera, Renato Front Pediatr Pediatrics There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second controller. In this scenario, mepolizumab, a humanized monoclonal antibody, has proven to be effective in controlling eosinophil proliferation by targeting interleukin-5 (IL-5), a key mediator of eosinophil activation pathways. Mepolizumab is approved since 2015 for adults at a monthly dose of 100 mg subcutaneously and it has been approved for patients ≥ 6 years of age in 2019. Especially in children aged 6 to 11 years, mepolizumab showed a greater bioavailability, with comparable pharmacodynamics parameters as in the adult population. The recommended dose of 40 mg every 4 weeks for children aged 6 through 11 years, and 100 mg for patients ≥ 12 years provides appropriate concentration and proved similar therapeutic effects as in the adult study group. A marked reduction in eosinophil counts clinically reflects a significant improvement in asthma control as demonstrated by validated questionnaires, reduction of exacerbation rates, and the number of hospitalizations. Finally, mepolizumab provides a safety and tolerability profile similar to that observed in adults with adverse events mostly of mild or moderate severity. The most common adverse events were headache and injection-site reaction. In conclusion, mepolizumab can be considered a safe and targeted step-up therapy for severe asthma with an eosinophilic phenotype in children and adolescents. Frontiers Media S.A. 2022-07-01 /pmc/articles/PMC9283570/ /pubmed/35844748 http://dx.doi.org/10.3389/fped.2022.920066 Text en Copyright © 2022 Ullmann, Peri, Florio, Porcaro, Profeti, Onofri and Cutrera. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Ullmann, Nicola
Peri, Francesca
Florio, Olivia
Porcaro, Federica
Profeti, Elisa
Onofri, Alessandro
Cutrera, Renato
Severe Pediatric Asthma Therapy: Mepolizumab
title Severe Pediatric Asthma Therapy: Mepolizumab
title_full Severe Pediatric Asthma Therapy: Mepolizumab
title_fullStr Severe Pediatric Asthma Therapy: Mepolizumab
title_full_unstemmed Severe Pediatric Asthma Therapy: Mepolizumab
title_short Severe Pediatric Asthma Therapy: Mepolizumab
title_sort severe pediatric asthma therapy: mepolizumab
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283570/
https://www.ncbi.nlm.nih.gov/pubmed/35844748
http://dx.doi.org/10.3389/fped.2022.920066
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