奥马珠单抗用于囊性纤维化患者的变应性支气管肺曲霉病治疗
Omalizumab in allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.
作者信息
Ashkenazi Moshe, Sity Saray, Sarouk Ifat, Bar Aluma Bat El, Dagan Adi, Bezalel Yael, Bentur Lea, De Boeck Kris, Efrati Ori
机构信息
Pediatric Pulmonology and National CF Center, Edmond and Lilly Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
J Asthma Allergy. 2018 Jun 19;11:101-107. doi: 10.2147/JAA.S156049. eCollection 2018.
BACKGROUND
Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by a Th2 response, serum eosinophilia, and increased total serum IgE to . ABPA occurs in cystic fibrosis (CF) and asthma. Omalizumab is a humanized recombinant monoclonal antibody against IgE. Previous studies reported borderline results when treating ABPA with omalizumab.
METHODS
A retrospective study to investigate the efficacy of omalizumab in the treatment of ABPA in CF patients was conducted at 3 CF centers in Israel and Belgium. Data were obtained from the digital archive. We measured 4 outcome parameters: forced expiratory volume in 1 second, body mass index, pulmonary exacerbations, and steroid sparing.
RESULTS
The database was composed on the records of 9 patients. None of the outcome parameters showed any improvement. A favorable outcome was observed in patients with higher levels of posttreatment total IgE than those with lower levels. CF-related diabetes and male gender showed trends for poorer outcomes.
CONCLUSION
No benefits were detected on treating ABPA in CF with omlaizumb. Monitoring the total IgE was not helpful. A prospective randomized double-blind study is needed.
背景
变应性支气管肺曲霉病（ABPA）是一种以Th2反应、血清嗜酸性粒细胞增多以及血清总IgE升高为特征的疾病。ABPA发生于囊性纤维化（CF）和哮喘患者中。奥马珠单抗是一种抗IgE的人源化重组单克隆抗体。既往研究报道使用奥马珠单抗治疗ABPA的结果存在争议。
方法
在以色列和比利时的3个CF中心进行了一项回顾性研究，以调查奥马珠单抗治疗CF患者ABPA的疗效。数据来自数字档案。我们测量了4个结局参数：第1秒用力呼气容积、体重指数、肺部加重次数以及激素减量情况。
结果
数据库由9例患者的记录组成。所有结局参数均未显示出任何改善。治疗后总IgE水平较高的患者观察到较好的结局，而水平较低的患者则不然。CF相关糖尿病和男性患者显示出结局较差的趋势。
结论
未发现使用奥马珠单抗治疗CF患者的ABPA有任何益处。监测总IgE并无帮助。需要进行一项前瞻性随机双盲研究。
Zotero 插件