Heart failure & cardiomyopathiesCohort study
Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-centre experience and systematic literature review
- single-centre experience and systematic literature review
- comparison with a contemporary cohort
- historical cohort treated without monoclonal antibodies (mAbs)
Authors' conclusion
In EM within eosinophilic disease, anti-IL-5/5R and anti-IL-4/13 mAbs showed steroid-sparing effects and favourable safety, suggesting potential benefit for disease control.
Study context
- Population
- Patients with eosinophilic myocarditis (EM) treated with mepolizumab, benralizumab, or dupilumab in combination with glucocorticoids and/or immunosuppressantsEM patients included · contemporary cohort 19 · from the literature 18
- Participants
- Thirty-seven patients
- Exposure
- mAb group vs conventional immunosuppressants alone
Main finding
As reported in the abstract
- mepolizumab
- 81%
- benralizumab
- 14%
- dupilumab
- 5%
- Median time to mAb initiation
- 2.5 months
- treatment duration
- 24 months
Observational data: associations, not effects.
Further findings
Myocarditis relapses and follow-up eosinophil counts
myocarditis relapses
follow-up eosinophil counts mAb group 0.04 × 109/L · conventional immunosuppressants alone 0.85 × 109/L
EM relapses, deaths, or heart transplantations
- No EM relapses, deaths, or heart transplantations occurred
Glucocorticoids tapered and withdrawn
- Glucocorticoids were tapered and withdrawn
- 89%
LVEF, TnI normalization, eosinophil reduction (contemporary cohort)
- improved LVEF
- 47%-55%, P = 0.004
- TnI normalization
- 95%-12%, P < 0.001
- eosinophil reduction
- 95%-11%, P < 0.001
- In the contemporary cohort
Safety
mAb discontinuations due to adverse events
- no mAb discontinuations due to adverse events
Original publication
Summarised from the published abstract; every number is checked against it