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贝那鲁肽在日本严重、未控制的嗜酸性粒细胞性哮喘患者中的疗效和安全性。

Efficacy and safety of benralizumab in Japanese patients with severe, uncontrolled eosinophilic asthma.

机构信息

National Hospital Organization, Tokyo National Hospital, Tokyo, Japan.

International University of Health and Welfare Sanno Hospital, Tokyo, Japan.

出版信息

Allergol Int. 2018 Apr;67(2):266-272. doi: 10.1016/j.alit.2017.10.004. Epub 2017 Nov 8.

Abstract

BACKGROUND

In the Phase III CALIMA trial, benralizumab significantly reduced asthma exacerbations, increased lung function, and alleviated symptoms for patients with severe, uncontrolled eosinophilic asthma. The aim of this subgroup analysis was to evaluate the efficacy and safety of benralizumab for Japanese patients in the CALIMA trial.

METHODS

CALIMA was a randomised, controlled trial of 1306 patients (aged 12-75 years; registered at ClinicalTrials.gov: NCT01914757) with severe asthma uncontrolled by medium- to high-dosage inhaled corticosteroids and long-acting β-agonists (ICS/LABA). Patients received 56 weeks' benralizumab 30 mg either every 4 weeks (Q4W) or every 8 weeks (Q8W; first three doses Q4W), or placebo Q4W. The primary analysis population was patients receiving high-dosage ICS/LABA with blood eosinophils ≥300 cells/μL. This subgroup analysis covered Japanese patients from this group.

RESULTS

Of 83 patients randomised in Japan, 46 were receiving high-dosage ICS/LABA and had blood eosinophils ≥300 cells/μL. Compared with placebo, benralizumab reduced the annual rate of asthma exacerbations by 66% (Q4W; rate ratio 0.34, 95% CI, 0.11-0.99) and 83% (Q8W; rate ratio 0.17, 95% CI, 0.05-0.60); increased prebronchodilator FEV by 0.334 L (Q4W; 95% CI, 0.020-0.647) and 0.198 L (Q8W; 95% CI, -0.118 to 0.514); and decreased total asthma symptom score by 0.17 (Q4W; 95% CI, -0.82 to 0.48) and 0.24 (Q8W; 95% CI, -0.87 to 0.40). Percentages of adverse events were consistent with the overall CALIMA group.

CONCLUSIONS

Benralizumab reduced annual asthma exacerbations and symptoms, increased lung function, and was well-tolerated by Japanese patients with severe, uncontrolled eosinophilic asthma.

摘要

背景

在 III 期 CALIMA 试验中,贝那鲁肽显著减少了哮喘恶化,改善了肺功能,缓解了重度、未控制的嗜酸性粒细胞性哮喘患者的症状。本亚组分析的目的是评估贝那鲁肽对 CALIMA 试验中日本患者的疗效和安全性。

方法

CALIMA 是一项针对 1306 例患者(年龄 12-75 岁;在 ClinicalTrials.gov 注册:NCT01914757)的随机对照试验,这些患者患有中至高剂量吸入皮质激素和长效β激动剂(ICS/LABA)未能控制的重度哮喘。患者接受 56 周贝那鲁肽 30mg,每 4 周(Q4W)或每 8 周(Q8W;前 3 剂 Q4W)或安慰剂 Q4W。主要分析人群为接受高剂量 ICS/LABA 治疗且血液嗜酸性粒细胞≥300 个/μL 的患者。本亚组分析涵盖了来自该组的日本患者。

结果

在日本随机分配的 83 例患者中,46 例接受高剂量 ICS/LABA 治疗且血液嗜酸性粒细胞≥300 个/μL。与安慰剂相比,贝那鲁肽将哮喘恶化的年发生率降低了 66%(Q4W;率比 0.34,95%CI,0.11-0.99)和 83%(Q8W;率比 0.17,95%CI,0.05-0.60);增加了支气管扩张剂前 FEV1 0.334L(Q4W;95%CI,0.020-0.647)和 0.198L(Q8W;95%CI,-0.118 至 0.514);总哮喘症状评分降低了 0.17(Q4W;95%CI,-0.82 至 0.48)和 0.24(Q8W;95%CI,-0.87 至 0.40)。不良事件的百分比与总体 CALIMA 组一致。

结论

贝那鲁肽减少了日本重度、未控制的嗜酸性粒细胞性哮喘患者的哮喘恶化和症状,改善了肺功能,且具有良好的耐受性。

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