APFED Blog: Research Roundup, December 2024

This blog post is a research roundup of recent publications on eosinophilic diseases, including summaries, links, and citations for the following articles:

Characteristics of Severe Asthma With Eosinophilic Granulomatosis With Polyangiitis

A study published in The Journal of Allergy and Clinical Immunology: In Practice suggests that EGPA is more common in people with severe asthma. It underscores for healthcare providers the importance of checking for additional symptoms in people who have high levels of eosinophils and working with other specialists to ensure proper care.

Youxin Puan, Kheng Yong Ong, Pei Yee Tiew, Gabriel Xu Wen Chen, Neville Wei Yang Teo, Andrea Hsiu Ling Low, Michael E. Wechsler, Mariko Siyue Koh. Characteristics of Severe Asthma Clinic Patients With Eosinophilic Granulomatosis With Polyangiitis, The Journal of Allergy and Clinical Immunology: In Practice, 2024, ISSN 2213-2198.

Game-changing Asthma Attack Treatment with Benralizumab

Benralizumab (Fasenra®) is a biologic treatment that made recent headlines after a study published in The Lancet Respiratory Medicine showed that giving patients an injection during an asthma flare-up was 30% more effective than the current standard treatment with steroid tablets, reducing the need for additional care. While benralizumab is already used in low doses as a long-term treatment for severe asthma, the trial demonstrated that a single higher dose at the time of a flare-up could provide powerful and immediate relief.

Ramakrishnan, Sanjay et al. Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial. The Lancet Respiratory Medicine, 2024.

Mepolizumab May Improve Underlying Airway Changes Associated with Asthma

A new study shows promising results for people with severe asthma using a treatment called mepolizumab (Nucala®). After a year of treatment, patients breathed better, had fewer asthma attacks, and showed signs of healing in their airways. The medicine not only helped with symptoms but also seemed to repair some of the damage asthma had caused to their lungs. This research suggests that mepolizumab could be a powerful tool for managing severe asthma and potentially improving the long-term health of patients’ airways.

Domvri K, Tsiouprou I, Bakakos P, Steiropoulos P, Katsoulis K, Kostikas K, Antoniou KM, Papaioannou AI, Rovina N, Katsaounou P, Papamitsou T, Pastelli N, Tryfon S, Fouka E, Papakosta D, Loukides S, Porpodis K. Effect of Mepolizumab in airway's remodelling in patients with late-onset severe asthma with an eosinophilic phenotype. The Journal of Allergy and Clinical Immunology. 2024 Nov 7:S0091-6749(24)01168-0. doi: 10.1016/j.jaci.2024.10.024. Epub ahead of print. PMID: 39521278.

Seasonal Patterns in Eosinophilic Esophagitis-Related Emergency Department Visits: A National Database Analysis

A study published in the American Journal of Gastroenterology looked at seasonal variations in EoE-related emergency department (ED) visits among adults. The authors report that among more than 18,000 EoE-related ED visits, they observed a significant seasonal variation that peaked in summer and lowering in winter. They also noted that the pattern was consistent across all U.S. regions, and that seasonal dietary habits and social behaviors likely contribute to EoE exacerbations.

Pan, Chun-Wei MD1,a; Dominguez, Alejandro Nieto MD1; Guifarro, Daniel MD1; Danpanichkul, Pojsakorn MD2; Pang, Maoyin MD, PhD3,a. Seasonal Patterns in Eosinophilic Esophagitis-Related Emergency Department Visits: A National Database Analysis. The American Journal of Gastroenterology ():10.14309/ajg.0000000000003226, November 26, 2024. | DOI: 10.14309/ajg.0000000000003226

Study Looks at Impact of Cannabis Use on Eosinophilic Esophagitis Treatment Outcomes

Researchers recently studied how cannabis use affects people with eosinophilic esophagitis (EoE) by examining 983 patients, of whom 80 reported cannabis use. Most cannabis users consumed the substance daily through inhalation.

They found that initially, cannabis users displayed milder esophageal inflammation, with fewer endoscopic signs of EoE. However, post-treatment analysis revealed these patients experienced greater inflammatory responses compared to non-users, despite similar symptom and histological improvements. This suggests that cannabis might make EoE harder to treat which could negatively affect EoE treatment outcomes.

Borinsky SA, Weir AA, LaFata SS, Gee TS, Thel HL, Cameron BA, Xue AZ, Kiran A, Ocampo AA, McCallen J, Lee CJ, Redd WD, Barlowe TS, Kaakati RN, Cotton CC, Eluri S, Reed CC, Dellon ES. Impact of cannabis use on presentation and treatment response in eosinophilic esophagitis. Diseases of the Esophagus. 2024 Oct 3:doae080. doi: 10.1093/dote/doae080. Epub ahead of print. PMID: 39363563.