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• W2988201919 abstract "Introduction and objectives Anti-IL5 therapies act by reducing blood and tissue eosinophils and are indicated in the management of patients with severe refractory eosinophilic Asthma. Eosinophils are important mediators in the host defence of parasitic infection. Prescribing guidelines recommend treatment of pre-existing parasitic infection prior to initiation of therapy. However, such infections are often chronic and asymptomatic and there is no clear guidance on who to screen and what to screen for. In addition, awaiting treatment by a specialist team can delay commencement of asthma therapy. We sought to review our current practice and to develop a comprehensive protocol to guide screening and treatment of occult parasitic infection in patients selected to receive anti-IL5 therapy. Methods A retrospective study of 219 severe asthma patients prescribed anti-IL5 therapy was performed to identify the prevalence of occult parasitic infection in this cohort. Anti-IL5 clinical trial protocols and infectious disease literature was also studied. Using these data, a protocol for parasite screening was developed. Results Fifty-six patients (26%) had parasite screening carried out based on travel outside of Europe or North America. Seven of the patients screened (12.5%) had a positive test. Each patient was screened for an average of 5 different parasites (total number of tests=303), however positive tests were for Strongyloides (n=3) or Schistosoma (n=4) only. A protocol which provides guidance for targeted screening for parasite infection and which includes comprehensive risk assessment and travel history was developed. Implementation of this protocol could reduce the number and costs of tests performed by 80% whilst maintaining the positive detection rate. The protocol incorporates additional guidance on how to manage and treat occult parasite infection when detected. Conclusions Despite being recommended prior to initiation of anti-IL5 therapy, there is no clear guidance on screening for parasitic infections in this cohort, which can lead to inadequate screening or unnecessary tests being performed. We have developed a protocol to streamline this process to ensure the right tests are performed for the right patient first time." @default.
• W2988201919 created "2019-11-22" @default.
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• W2988201919 date "2019-11-12" @default.
• W2988201919 modified "2023-09-24" @default.
• W2988201919 title "S52 Development of a dedicated protocol for screening for occult parasitic infection prior to initiation of anti-IL5 therapy in patients with severe eosinophilic asthma" @default.
• W2988201919 doi "https://doi.org/10.1136/thorax-2019-btsabstracts2019.58" @default.
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