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Review
. 2024 Jan 5:14:1310211.
doi: 10.3389/fimmu.2023.1310211. eCollection 2023.

Expert consensus on the use of systemic glucocorticoids for managing eosinophil-related diseases

Victoria Del Pozo  1 , Irina Bobolea  2 , Manuel J Rial  3   4 , Georgina Espigol-Frigolé  5 , Roser Solans Laqué  6 , Jesús María Hernández-Rivas  7 , Elvira Mora  8 , Astrid Crespo-Lessmann  9 , José Luis Izquierdo Alonso  10   11 , María Sandra Domínguez Sosa  12 , Juan Maza-Solano  13 , Belén Atienza-Mateo  14 , David Bañas-Conejero  15 , Abraham L Moure  15 , Íñigo Rúa-Figueroa  16
Affiliations
Review

Expert consensus on the use of systemic glucocorticoids for managing eosinophil-related diseases

Victoria Del Pozo et al. Front Immunol. .

Abstract

Eosinophil-related diseases represent a group of pathologic conditions with highly heterogeneous clinical presentation and symptoms ranging from mild to critical. Both systemic and localized forms of disease are typically treated with glucocorticoids. The approval of novel biologic therapies targeting the interleukin-5 pathway can help reduce the use of systemic glucocorticoids (SGC) in eosinophilic diseases and reduce the risk of SGC-related adverse effects (AEs). In this article, a panel of experts from different medical specialties reviewed current evidence on the use of SGC in two systemic eosinophilic diseases: Eosinophilic Granulomatosis with PolyAngiitis (EGPA) and HyperEosinophilic Syndrome (HES); and in two single-organ (respiratory) eosinophilic diseases: Chronic RhinoSinusitis with Nasal Polyps (CRSwNP) and Severe Asthma with Eosinophil Phenotype (SA-EP), and contrasted it with their experience in clinical practice. Using nominal group technique, they reached consensus on key aspects related to the dose and tapering of SGC as well as on the initiation of biologics as SGC-sparing agents. Early treatment with biologics could help prevent AEs associated with medium and long-term use of SGC.

Keywords: adverse events; biologics; eosinophilic diseases; systemic glucocorticoids; tapering; treatment optimisation.

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Conflict of interest statement

VP has received consulting, speaker fees, grants and support to attend international congresses from AstraZeneca, GSK and Sanofi. IB has received fees from GSK, Novartis, Sanofi, AstraZeneca and Teva for talks at scientific events and as member of advisory boards. MJR has received lecture fees from Novartis, GSK, LETI, Astra-Zéneca, Chiesi and TEVA. GE-F has received consulting fees from GSK and Janssen and support to attend congress from Boehringer Ingelheim. RSL has received consulting fees from GSK and support to attend congresses from Menarini. JMH-R has received honoraria from Amgen, Novartis, Celgene/BMS, Pfizer and GSK and is a member of Novartis, Pfizer, Amgen and Celgene/BMS advisory boards. He has received consulting fees from GSK and research support from Novartis and Celgene/BMS. EM has received consulting fees from GSK. AC-L has received fees in the last 3 years for talks at meetings sponsored by AstraZeneca, Bial, Boehringer Ingelheim, Chiesi, Ferrer, GlaxoSmithKline, MSD, Novartis, Orion Pharma, and Sanofi; travel and attendance expenses for conferences from Bial, Gebro, GlaxoSmithKline, Novartis, and TEVA; and funds/grants for research projects from several state agencies, non-profit foundations, and AstraZeneca and GlaxoSmithKline. JLIA has received fees for consultancy, projects, and talks from AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, Glaxo, Grifols, Smith Kline, Menarini, Novartis, Orion, Pfizer, Sandoz, and Teva. MSDS has received fees from GSK, Sanofi, MSD and MEDA for talks at scientific events and is a member of advisory boards. JM-S has received fees from GSK, Sanofi, AstraZeneca and Teva for talks at scientific events and as member of advisory boards. BA-M has received grants and research support from Abbvie and Roche, and fees for consulting or participating in company-sponsored speakers bureaus from GSK, Boehringer Ingelheim and Janssen. DB-C and ALM are employees of GSK and hold stocks/shares in GSK. ÍR-F: has received consulting fees from GSK and is on GSK’s advisory board for mepolizumab.

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