ORIGINAL RESEARCH article
Front. Allergy
Sec. Therapies and Therapeutic Targets
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1605397
Steroid-sparing benefits of biologic use in hypereosinophilic syndrome and substantial disease burden across subtypes
Provisionally accepted
- 1GSK, Mississauga, Canada
- 2Analysis Group (United States), Boston, Massachusetts, United States
- 3University of Cincinnati School of Medicine, Cincinnati, United States
- 4GSK, Collegeville, United States
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Background: Limited data exist on the burden of myeloproliferative, lymphocytic and idiopathic subtypes of hypereosinophilic syndrome (M-HES, L-HES and I-HES) and the characteristics of patients with HES receiving biologic therapies. This analysis aimed to further characterize these subtypes and explore the impact of biologics in a real-world European setting.Methods: This was a post hoc subgroup analysis of a retrospective, non-interventional, chart review (GSK ID: 214657) across five European countries. Index date was first clinical visit during January 2015-December 2019 (after or at time of HES diagnosis). Patients with HES aged ≥6 years with ≥1-year follow-up from index were included. Demographics, disease characteristics, diagnostic assessments, comorbidities, types of treatment, clinical manifestations, clinical outcomes and HES-related healthcare resource utilization were summarized for HES overall and subtypes. Oral corticosteroid (OCS) use and clinical manifestations/outcomes were assessed 12-months pre-and post-biologics. Results: The analysis included 280 patients with I-HES (n=155), M-HES (n=66), L-HES (n=42) and chronic eosinophilic leukemia (n=2). The most common clinical manifestations were fatigue (54.2% I-HES, 52.4% L-HES, 42.4% M-HES), skin itch (36.4% M-HES, 35.7% L-HES, 33.5% I-HES) and pain (31.0% L-HES, 30.3% M-HES, 27.1% I-HES). Biologic use was highest with L-HES (64.3%), followed by I-HES (43.9%) and M-HES (34.8%). Clinical response rates were highest for the I-HES subtype (75.5%; 66.7% L-HES, 63.6% M-HES). Hospitalizations were highest for L-HES (45.2%; 30.3% M-HES, 25.8% I-HES). The annualized rate of OCS prescriptions reduced by 56.8% (0.44 to 0.19 per person-year) and the proportion of patients with ≥1 clinical response increased 3.6-fold (6.5% to 23.4%) between the pre-and post-biologics periods.Conclusions: All HES subtypes had a substantial disease burden and were commonly associated with fatigue, skin itch and pain. I-HES appeared to be more responsive to treatment than L-HES and M-HES. Biologic use for HES led to more patients experiencing clinical responses and was OCS-sparing.
Keywords: Hypereosinophilic Syndrome, burden of disease, biologics, Mepolizumab, Retrospective study, corticosteroid
Received: 03 Apr 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Hwee, Huynh, Da Costa, Rothenberg, Duh and Alfonso-Cristancho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jeremiah Hwee, GSK, Mississauga, Canada
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