Treatment of Chronic Eosinophilic Pneumonia with Elevated IgE
This protocol addresses chronic eosinophilic pneumonia in patients where steroid-sparing biologic therapy is indicated, with particular consideration for those presenting with an elevated IgE level.
Treatment approach
The regimen centres on steroid-sparing biologic agents targeting IgE or eosinophil-regulatory pathways. Selection among available agents depends on the patient's IgE level and other clinical factors — the full criteria, agent sequencing, and dosing protocol are available in the complete regimen.
Clinical goals
Decreased peripheral blood eosinophilia and resolution of pulmonary symptoms.
References
DOI: 10.2147/TCRM.S157882
- Omalizumab, a monoclonal antibody against IgE, was used in a patient with CEP after the second relapse in 2 years.
- This patient had an elevated IgE and responded to the omalizumab injections.
- They were able to taper the dose of omalizumab by 50% every 6 months.
- Eighteen months after initial presentation, mepolizumab was started at a dose of 100 mg every 4 weeks.
- Therefore, reslizumab at a dose of 3 mg/kg was initiated every 4 weeks.
- Mepolizumab and reslizumab prevent binding of circulating IL-5 to eosinophils.
- After starting this therapy, her peripheral blood eosinophilia decreased, and her symptoms disappeared while tapering her glucocorticoids.
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