(Adnkronos) - “L’anticorpo monoclonale mepolizumab permette di bloccare l'interleuchina 5, il fattore di crescita più specifico e principale degli eosinofili, i key driver della patogenesi Egpa”, granulomatosi eosinofila con poliangioite, “una malattia che va incontro a recidive. Mepolizumab permette di poter allungare il tempo alla prima recidiva”. Così Francesco Bini, direttore dell’Uoc di Pneumologia dell’Asst-Rhodense di Garbagnate Milanese, intervenendo a Milano durante la seconda giornata del XXV congresso nazionale della Società italiana di pneumologia (Sip), al simposio Gsk sulle malattie eosinofile e l’evoluzione dell’approccio terapeutico dell’anticorpo monoclonale.
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00:00What is the incidence of E. coli in Italy?
00:04The incidence of E. coli in Italy
00:08must always be remembered that it is a rare disease,
00:13that is, we actually have a low incidence,
00:15a low prevalence compared to the large numbers of more common diseases.
00:19On average, the incidence is between 2 and 7 cases per million inhabitants,
00:24while the prevalence is between 10 and 13 cases per million inhabitants,
00:28so basically we have a thousand patients in Italy currently diagnosed.
00:35Classically, in patients with E. coli I find a patient with severe asthma,
00:39in which I have a loss of control of the asthma,
00:42a worsening of the asthma, otherwise not explained,
00:45not explained with an infectious exacerbation or any other genesis,
00:49and that is the moment when I have to think about the appearance,
00:53the development of a vasculite like E. coli,
00:56because I have lost control of the asthma for unknown reasons.
00:59This is the diagnosis suspicion that all probiologists,
01:03allergologists, rheumatologists must have in mind.
01:07In the maintenance of the disease and then in the treatment of the relapses of the disease,
01:11that is, of the recovery of the disease,
01:14since 2017, from the MIRRA study,
01:17we have the possibility of using a monoclonal antibody against interleukin A5.
01:23As I said before, interleukin A5 is central in the treatment,
01:26in the pathogenesis of EGPA.
01:28This monoclonal antibody is called mepolizumab
01:31and allows to block interleukin A5,
01:34which in turn is the most specific and main growth factor of eosinophils,
01:38which are the key driver cell of the pathogenesis of the vasculitic disease called EGPA.
01:45That is, they are the cell that orchestrates the damage
01:49and orchestrates the natural history of the disease itself.
01:53So today we have the possibility of using this monoclonal antibody
01:56in the maintenance and in the refractory disease,
02:01that is, in the disease that is still active,
02:04it has not yet fully responded to the inductive therapy.
02:07And what does this allow?
02:09It allows to be able to save, first of all, the glucocorticoids,
02:12that is, I can have a reduction of the amount of systemic steroid
02:17that I give to my patients,
02:18with all the consequent advantages of reducing systemic steroid exposure.
02:24Advantages on the side effects, which are really very broad,
02:28the glucocorticoids, let's just mention diabetes,
02:30the risk of infectious diseases, osteoporosis, hypertension, eye damage.
02:35And then, mepolizumab also allows to have an increase in the weeks
02:40in which the pathology is under control,
02:43that is, the time from the first relapse, from the first recovery, of the disease.
02:47Because eGPA is classically a disease that goes against
02:50recovery of disease, recidivism of disease,
02:53and mepolizumab allows to be able to extend the time to the first recidivism, basically.