贝那利珠单抗、美泊利单抗与奥马珠单抗治疗与鼻息肉相关的严重过敏性哮喘的实际疗效
2022/05/17
摘要
生物疗法可用于治疗血液嗜酸性粒细胞计数≥0.3×109/L的严重过敏性哮喘 (SAA)， 其中一些还显示出对的鼻息肉 (NP) 的益处，鼻息肉是严重哮喘最常见的合并症之一，但目前缺乏关于生物疗法在 SAA-NP关联中的有效性的比较研究。本研究的目的是比较贝那利珠单抗、美泊利单抗和奥马珠单抗在真实世界中对 SAA-NP 患者的疗效。我们完成了一项回顾性，观察性，多中心的真实世界研究，即用贝那利珠单抗、美泊利单抗和奥马珠单抗治疗SAA-NP患者6个月，并分析了鼻腔和呼吸道症状，哮喘发作次数和沙丁胺醇每周的使用量，急性鼻窦炎及急性加重率，哮喘控制评分，肺功能参数，NP内镜评分，鼻窦成像和治疗前后6个月的血液嗜酸性粒细胞计数。纳入72例SAA-NP患者：16例使用贝那利珠单抗治疗，21例使用美泊利单抗治疗，35例使用奥马珠单抗治疗。经过6个月的治疗，几乎所有研究参数都得到改善（鼻窦成像除外），奥马珠单抗对鼻瘙痒的影响更大（p = 0.001），贝那珠单抗对急性加重率，每周哮喘发作和肺功能的益处更多（all p<0.05）。贝那利珠单抗、美泊利单抗在改善NP内镜评分和血液嗜酸性粒细胞计数方面更有效（both p<0.001）。三种生物疗法均通过改善SAA-NP患者的哮喘和鼻腔结局而显示出有效性。它们之间的疗效差异应该通过更大规模的比较研究来证实。
Real‑Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps
Angelica Tiotiu, Paula Mendez-Brea
Abstrast
Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.
生物疗法可用于治疗血液嗜酸性粒细胞计数≥0.3×109/L的严重过敏性哮喘 (SAA)， 其中一些还显示出对的鼻息肉 (NP) 的益处，鼻息肉是严重哮喘最常见的合并症之一，但目前缺乏关于生物疗法在 SAA-NP关联中的有效性的比较研究。本研究的目的是比较贝那利珠单抗、美泊利单抗和奥马珠单抗在真实世界中对 SAA-NP 患者的疗效。我们完成了一项回顾性，观察性，多中心的真实世界研究，即用贝那利珠单抗、美泊利单抗和奥马珠单抗治疗SAA-NP患者6个月，并分析了鼻腔和呼吸道症状，哮喘发作次数和沙丁胺醇每周的使用量，急性鼻窦炎及急性加重率，哮喘控制评分，肺功能参数，NP内镜评分，鼻窦成像和治疗前后6个月的血液嗜酸性粒细胞计数。纳入72例SAA-NP患者：16例使用贝那利珠单抗治疗，21例使用美泊利单抗治疗，35例使用奥马珠单抗治疗。经过6个月的治疗，几乎所有研究参数都得到改善（鼻窦成像除外），奥马珠单抗对鼻瘙痒的影响更大（p = 0.001），贝那珠单抗对急性加重率，每周哮喘发作和肺功能的益处更多（all p<0.05）。贝那利珠单抗、美泊利单抗在改善NP内镜评分和血液嗜酸性粒细胞计数方面更有效（both p<0.001）。三种生物疗法均通过改善SAA-NP患者的哮喘和鼻腔结局而显示出有效性。它们之间的疗效差异应该通过更大规模的比较研究来证实。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Clinical reviews in allergy & immunology,2022 Apr 14; doi:10.1007/s12016-022-08938-w.)
(Clinical reviews in allergy & immunology,2022 Apr 14; doi:10.1007/s12016-022-08938-w.)
Real‑Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps
Angelica Tiotiu, Paula Mendez-Brea
Abstrast
Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.
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儿童肥胖相关哮喘的内分型：人体测量、代谢、营养和CD4+淋巴细胞对肺功能的影响
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U-BIOPRED队列中持续恶化的严重哮喘的临床和转录组特征
