Nasal IL-5 levels determine the response to anti–IL-5 treatment in patients with nasal polyps - 18/08/11
, Doris Lang-Loidolt, MD b, Andreas Lackner, MD b, Heinz Stammberger, MD b, Heribert Staudinger, MD, PhD c, Thibaut Van Zele, MD a, Gabriele Holtappels a, Jan Tavernier, PhD d, Paul van Cauwenberge, MD, PhD a, Claus Bachert, MD, PhD a
Reprint requests: Philippe Gevaert, MD, PhD, Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium.Ghent, Belgium, Graz, Austria, and Kenilworth, NJ
Abstract |
Background |
Chronic rhinosinusitis with nasal polyps is characterized by an eosinophilic inflammation and high IL-5 levels.
Objectives |
Antagonizing the effect of IL-5 is a potential new treatment strategy in patients with nasal polyps.
Methods |
In a double-blind, placebo-controlled, randomized, 2-center safety and pharmacokinetic study, 24 subjects with bilateral nasal polyps were randomized to receive a single intravenous infusion of reslizumab, a humanized anti-human IL-5 mAb, at 3 mg/kg or 1 mg/kg or placebo. We evaluated the safety and pharmacokinetics of reslizumab, and biologic activity was assessed by means of endoscopic evaluation of polyp size, symptoms, peripheral eosinophil counts, peripheral and local IL-5 levels, eotaxin levels, and eosinophil cationic protein levels.
Results |
We demonstrated that a single injection of reslizumab up to 3 mg/kg is safe and well tolerated. Blood eosinophil numbers and concentrations of eosinophil cationic protein were reduced up to 8 weeks after treatment in serum and nasal secretions. Individual nasal polyp scores improved only in half of the treated patients for 4 weeks. Responders had increased IL-5 concentrations in nasal secretions at baseline compared with nonresponders, and logistic regression analysis revealed that increased nasal IL-5 levels (>40 pg/mL) predict the response to anti-IL-5 treatment.
Conclusion |
A single injection of anti–IL-5 reduces the size of nasal polyps for 4 weeks in half of the patients, and nasal IL-5 levels predict the response to anti–IL-5 treatment.
Clinical implications |
Intravenous administration of a humanized anti-human IL-5 mAb is safe and reduces the size of nasal polyps in half of the patients.
Le texte complet de cet article est disponible en PDF.Key words : Chronic rhinosinusitis, nasal polyps, eosinophils, IL-5, IL-5 receptor ⍺, anti–IL-5
Abbreviations used : ECP, NP, SOL IL-5R⍺
Plan
| Supported by Schering-Plough Research Institute, Kenilworth, NJ. Disclosure of potential conflict of interest: H. Staudinger is employed by and owns stock in Schering-Plough Corp. The rest of the authors have declared that they have no conflict of interest. |
Vol 118 - N° 5
P. 1133-1141 - novembre 2006 Retour au numéro
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