University of Catania-AOU Policlinico-V. Emanuele, Department of Clinical and Molecular Bio-Medicine-Institute of Internal Medicine and Clinical Immunology, Catania, 95124, Italy.
Expert Opin Biol Ther. 2013 Mar;13(3):393-402. doi: 10.1517/14712598.2013.743989. Epub 2013 Jan 7.
Patients with severe asthma have a significant unmet need with persistent symptoms and/or frequent exacerbations despite high intensity treatment. These severe unrelenting symptoms have a huge impact on heathcare resources due to frequent hospital admissions and requirement for intensive and expensive medications. There is a compelling need for more effective and safer therapies to help severe asthma sufferers to achieve adequate control of their disease.
Expanding knowledge of innate and adaptive immune responses has led to development of new biologic approaches for severe asthma. Here, the authors will review the existing efficacy and safety data from clinical trials of some of the new biologic therapies that are in development for severe asthma. Their specific role in distinctively targeted subpopulations of severe asthmatics will be also discussed.
Defining and phenotyping severe asthma patients will become increasingly important as some patients who were previously classified as having severe asthma may become well-controlled with a targeted phenotype-specific treatment. However, pharmacoeconomic concerns should also be taken into account given the elevated acquisition costs of recombinant human monoclonals and of the diagnostic screening procedures for the identification of potential responders.
尽管采用了高强度治疗，但严重哮喘患者仍存在持续症状和/或频繁恶化的情况，其需求仍未得到满足。这些严重且持续的症状对医疗资源造成了巨大影响，因为患者经常需要住院治疗，并且需要使用强效且昂贵的药物。因此，迫切需要更有效和更安全的治疗方法，帮助严重哮喘患者实现疾病的充分控制。
固有和适应性免疫反应知识的扩展，推动了严重哮喘新型生物疗法的发展。作者将在此回顾一些正在开发中的用于严重哮喘的新型生物疗法的临床试验的现有疗效和安全性数据。作者还将讨论这些疗法在特定靶向严重哮喘亚群中的具体作用。
随着一些以前被归类为严重哮喘的患者可能通过针对特定表型的治疗得到良好控制，定义和表型严重哮喘患者将变得越来越重要。然而，由于重组人单克隆抗体的高昂购置成本以及用于确定潜在应答者的诊断筛选程序，药物经济学方面的考虑也应该被纳入。
