ArticleThe journal of allergy and clinical immunology. Global2026
Real-world outcomes after anti-IL-5/anti-IL-5Rα treatment for hypereosinophilic syndrome: Systematic literature review.
Article in The journal of allergy and clinical immunology. Global, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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