Royal Brompton Hospital, London, UK.
Clin Med (Lond). 2013 Oct;13(5):477-81. doi: 10.7861/clinmedicine.13-5-477.
Asthma is a heterogeneous condition with multiple phenotypes that respond to treatments in different ways. Allergic asthma is an important phenotype and although currently available treatments are effective, about 5% of affected patients have severe, treatment-refractory disease. Despite advances in our understanding of the disease, there remains an unmet need in this group of patients. The most recent and significant advance in treatment has been anti--immunoglobulin E (IgE) therapy, which improves symptoms and quality of life in patients with severe allergic asthma. Clinical trials are ongoing with novel biologic agents that demonstrate potential efficacy; determining the subsets of patients for which they are suitable will be crucial to ensure cost effectiveness. Personalised medicine and targeted therapies may hold the key to long-term control in this group of patients.
哮喘是一种异质性疾病,具有多种表型,对治疗的反应也不同。过敏性哮喘是一种重要的表型,尽管目前可用的治疗方法有效,但约 5%的患者患有严重的、治疗抵抗性疾病。尽管我们对这种疾病的认识有所提高,但这组患者仍存在未满足的需求。治疗方面最近和最重要的进展是抗免疫球蛋白 E(IgE)治疗,它可改善严重过敏性哮喘患者的症状和生活质量。正在进行临床试验以评估新型生物制剂的潜在疗效;确定它们适用的患者亚组对于确保成本效益至关重要。个性化医疗和靶向治疗可能是这群患者长期控制的关键。