Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review.
S, G.A., C, M., A, B., F, S., C, V., F, D., L, I., R, M., M, D.G., S, R., C, B., R, P., & P, C.A.L. (2026). Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review.. Eur Heart J Cardiovasc Pharmacother. https://doi.org/10.1093/ehjcvp/pvag025
S GA, C M, A B, F S, C V, F D, et al. Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review.. Eur Heart J Cardiovasc Pharmacother. 2026; doi: 10.1093/ehjcvp/pvag025
S GA, C M, A B, et al. Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review.[J]. Eur Heart J Cardiovasc Pharmacother. 2026. DOI: 10.1093/ehjcvp/pvag025.
@article{s2026,
author = {Giordani A S and Menghi C and Baritussio A and Scognamiglio F and Vicenzetto C and Davanzo F and Iorio L and Marcolongo R and De Gaspari M and Rizzo S and Basso C and Padoan R and Caforio A L P},
title = {Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review.},
journal = {Eur Heart J Cardiovasc Pharmacother},
year = {2026},
doi = {10.1093/ehjcvp/pvag025},
note = {PMID: 42011880},
}
TY - JOUR AU - Giordani A S AU - Menghi C AU - Baritussio A AU - Scognamiglio F AU - Vicenzetto C AU - Davanzo F AU - Iorio L AU - Marcolongo R AU - De Gaspari M AU - Rizzo S AU - Basso C AU - Padoan R AU - Caforio A L P TI - Monoclonal antibodies targeting IL-5/5R or IL-4/13 pathways in eosinophilic myocarditis: a single-center experience and systematic literature review. T2 - Eur Heart J Cardiovasc Pharmacother PY - 2026 DO - 10.1093/ehjcvp/pvag025 AN - PMID:42011880 ER -
Eosinophilic myocarditis (EM) is a rare inflammatory heart disease often associated with eosinophilic granulomatosis with polyangiitis or hypereosinophilic syndrome. While anti-IL-5/5R and anti-IL-4/13 monoclonal antibodies (mAbs) efficacy in systemic eosinophilic diseases is established, data on EM are lacking. We aimed to: (1) characterize a single-center cohort of EM patients treated with mepolizumab, benralizumab, or dupilumab in combination with glucocorticoids and/or immunosuppressants; (2) systematically review published cases, comparing them with a contemporary cohort; (3) evaluate myocardial response and safety of mAbs in EM, in comparison with a historical cohort treated without mAbs at our center. Thirty-seven EM patients were included (19 from a contemporary cohort, 18 from the literature; 51% male; median age 47 years). Biologic treatments were mepolizumab (81%), benralizumab (14%), and dupilumab (5%). Median time to mAb initiation was 2.5 months; treatment duration 24 months. No EM relapses, deaths, or heart transplantations occurred. Glucocorticoids were tapered and withdrawn in 89% of cases, with no mAb discontinuations due to adverse events. In the contemporary cohort, mAb therapy was associated with improved LVEF (47% to 55%, p = 0.004), TnI normalization (95% to 12%, p < 0.001), and eosinophil reduction (95% to 11%, p < 0.001). Compared to EM patients managed with conventional immunosuppressants alone, the mAb group had no myocarditis relapses (0% vs. 25%) and lower follow-up eosinophil counts (0.04 ×109/L vs 0.85 ×109/L). In EM within eosinophilic disease, anti-IL-5/5R and anti-IL-4/13 mAbs showed steroid-sparing effects and favorable safety, suggesting potential benefit for disease control.