Switching from omalizumab to mepolizumab therapy improved extra‐pulmonary abdominal and cutaneous vasculitis symptoms in a patient with eosinophilic granulomatosis with polyangiitis

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis of small‐to‐medium‐sized vessels. Both eosinophilic infiltration and vasculitis are thought to contribute to multi‐organ damage. Some biologics have been used to reduce the required dose of corticosteroids in EGPA, but no...

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Bibliographic Details
Published in:Respirology case reports 2022-01, Vol.10 (1), p.n/a
Main Authors: Chen, Yu‐Hsuan, Kuo, Ping‐Hung
Format: Article
Language:English
Subjects:
Abdomen
Asthma
Biological products
Case Report
Case Reports
Diarrhea
eosinophilic granulomatosis with polyangiitis
extra‐pulmonary
Hospitalization
mepolizumab
omalizumab
Outpatient care facilities
Patients
Remission (Medicine)
Steroids
switching
Tomography
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Summary:Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis of small‐to‐medium‐sized vessels. Both eosinophilic infiltration and vasculitis are thought to contribute to multi‐organ damage. Some biologics have been used to reduce the required dose of corticosteroids in EGPA, but no single agent can ensure a complete control of this disease. Here, we describe a patient with anti‐neutrophil cytoplasmic antibodies‐negative relapsing EGPA whose asthma control was improved by omalizumab, but she continued to develop flares of abdominal and cutaneous vasculitis symptoms. After switching to mepolizumab therapy, her blood hypereosinophilia and extra‐pulmonary symptoms were significantly improved. Moreover, the dose of daily maintenance corticosteroid could be tapered off. The experience from our case suggests that biologics targeting interleukin‐5 may be more effective than omalizumab in the management of extra‐thoracic manifestations in EGPA. We report the clinical benefits after switching from omalizumab to mepolizumab in an anti‐neutrophil cytoplasmic antibodies‐negative eosinophilic granulomatosis with polyangiitis patient on her abdominal and cutaneous manifestations.
ISSN:2051-3380
2051-3380
DOI:10.1002/rcr2.878