Perfilamiento del paciente con asma grave eosinofílica para el tratamiento biológico con Mepolizumab y su efectividad en el control de la enfermedad

Abstract

Background: Management of severe eosinophilic asthma includes typing to identify allergic, eosinophilic and non-HT2 phenotypes. Elevated eosinophil levels are associated with higher IL-5 levels. Eosinophils during their migration to target tissues secrete proteins that damage the activated bronchial epithelium and correlate with asthma severity. Mepolizumab, a humanized monoclonal antibody that binds and neutralizes IL-5.

Objectives: To describe experience with the use of biological anti interleukin 5 Mepolizumab. Methodology: Case report, descriptive study. We included patients with severe uncontrolled asthma, a history of rhinosinusitis with nasal polyposis and/or EREA. Eosinophils 150 cells/μL, FeNO 25 ppb and spirometry with obstructive pattern.

Results: 6 women with a diagnosis of severe asthma were included. Initial eosinophil values of 180 - 630 cél/μL, IgE 176 - 2500 Ui/ml, FENO 23 -39, ACT at 2, 4 and 6 months of use, minimum of 9 and maximum end of 25. Significant improvement in the ACT test from the first two months of use, decreased inhaled steroid and 0 to 2 exacerbations in 6 months.

Discussion: There are multiple studies, there are no statistically significant reports to demonstrate superiority with the use of a specific biological, together with the different economic limitations that exist in the country. Conclusion: It is necessary to identify target populations with phenotypes that will respond to a specific therapy and direct treatment.

In Mexico there are few hospitals with these therapies, it is necessary to continue with the constant evaluation and contribution of information to find the right treatment for the Mexican population.