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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".