Real-world outcomes after anti–IL-5/anti–IL-5Rα treatment for hypereosinophilic syndrome: Systematic literature review
Bibliographic record
Abstract
Background: Anti-IL-5/anti-IL-5 receptor alpha (anti-IL-5/anti-IL-5Rα) treatments have potential to improve outcomes in hypereosinophilic syndrome (HES), as demonstrated in clinical trials. Objective: We sought to understand the real-world outcomes of anti-IL-5/anti-IL-5Rα treatments in patients with HES. Methods: This systematic literature review searched English-language articles (November 4, 2015, to October 31, 2023) and conference abstracts (January 1, 2021, to October 31, 2023) from MEDLINE/Embase and select conferences for publications containing outcomes for patients with HES receiving anti-IL-5 (mepolizumab [approved], reslizumab) or anti-IL-5Rα (benralizumab) treatment in the real world. Meta-analyses and clinical trials were excluded. Outcomes included treatment response, blood eosinophil (bEOS) counts, and oral corticosteroid (OCS) receipt. No formal bias assessment was conducted. Results: Five cohort studies (192 participants) and 55 case reports (70 participants) were identified. In cohort studies, median age was 44.0 to 61.8 years; 33.3% to 62.9% were female, and 45.5% to 100% had idiopathic HES. Mean (standard deviation) age in case reports (n = 68/70) was 38.5 (23.7) years; 40.0% (n = 28/70) were female, and 67.2% (n = 39/58) had idiopathic HES. Across 4 cohort studies, most patients had reduced or no HES flares after mepolizumab or benralizumab. In patients from case reports, 13 had HES flares (mepolizumab, n = 12/54; benralizumab, n = 1/13) after anti-IL-5/anti-IL-5Rα initiation. Mean bEOS counts were reduced by 53.0% to 100% across 3 cohort studies and by 95.0% in case reports. Of those receiving benralizumab or mepolizumab, OCS dose was reduced in 49.0% to 100% of patients from cohort studies, and by ≥50% in 29 of 70 patients from case reports. Conclusion: Real-world anti-IL-5/anti-IL-5Rα therapy in HES is associated with fewer flares as well as reductions in bEOS counts and OCS dose, although confirmatory studies in larger populations are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.046 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.010 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".