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奥马珠单抗对10例重度持续性哮喘患者的治疗效果

[Therapeutic effect of omalizumab on 10 patients with severe persistent asthma].

作者信息

Kanemitsu Yoshihiro, Kita Hideo, Fuseya Yoshinori, Tanimura Kazuya, Katayama Yuko, Nisihara Yumi

机构信息

Department of Respiratory Medicine, Takatsuki Red Cross Hospital.

出版信息

Arerugi. 2010 Aug;59(8):965-73.

Abstract

BACKGROUND

Therapeutic effect of omalizumab was studied in Japanese patients with severe asthma.

METHODS

Omalizumab was administered to 10 patients with bronchial asthma diagnosed as severe or very severe persistent asthma according to Asthma Prevention Management Guideline 2009, Japan (JGL 2009). Therapeutic efficacy was assessed 16 weeks after starting the treatment using Asthma Control Test (ACT), pulmonary function tests, and the peripheral eosinophil counts. In addition, number of acute exacerbation in 16-week period after starting the treatment was compared with that in 16-week period before the treatment and the previous year respectively. The questionnaire whether or not to continue omalizumab was conducted 16 weeks after starting the treatment.

RESULTS

The total ACT score rose from 14.8 to 19.1 and peripheral eosinophil count decreased from 355.2 /microl to 209.8 /microl after starting the treatment. Peak expiratory flow and forced expiratory volume in one second also increased, though differences were insignificant. Number of acute exacerbation decreased from 3.0 times before the treatment and 2.4 times the same time last year to 1.3 times after starting the treatment. The result of the questionnaire revealed that patients wanted to discontinue because of financial burden, ambulant burden, and side effect, but no one responded to be ineffective. In fact, only the one discontinued omalizumab.

CONCLUSION

Omalizumab produced improvement in subject symptoms and reduced acute exacerbation in patients with severe or very severe persistent asthma. The future challenge is to reduce financial and ambulant burden on patients.

摘要

背景

在日本重度哮喘患者中研究了奥马珠单抗的治疗效果。

方法

根据日本《2009年哮喘预防管理指南》(JGL 2009),对10例被诊断为重度或极重度持续性哮喘的支气管哮喘患者给予奥马珠单抗治疗。在开始治疗16周后,使用哮喘控制测试(ACT)、肺功能测试和外周血嗜酸性粒细胞计数评估治疗效果。此外,分别将开始治疗后16周内的急性加重次数与治疗前16周内以及上一年的急性加重次数进行比较。在开始治疗16周后进行了关于是否继续使用奥马珠单抗的问卷调查。

结果

开始治疗后,ACT总分从14.8升至19.1,外周血嗜酸性粒细胞计数从355.2/微升降至209.8/微升。呼气峰值流速和一秒用力呼气量也有所增加,尽管差异不显著。急性加重次数从治疗前的3.0次和去年同期的2.4次降至开始治疗后的1.3次。问卷调查结果显示,患者因经济负担、出行负担和副作用而希望停药,但没有人认为治疗无效。实际上,只有1例患者停用了奥马珠单抗。

结论

奥马珠单抗可改善重度或极重度持续性哮喘患者的症状,并减少急性加重次数。未来的挑战是减轻患者的经济和出行负担。

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