Imai Akira, Takizawa Takumi, Sato Koichiro, Inoue Takaharu, Nishida Yutaka, Yagi Hisako, Arakawa Hirokazu
Gunma University, Graduate School of Medicine, Department of Pediatrics.
National Hospital Organization, Takasaki General Medical Center, Pediatrics.
Arerugi. 2019;68(7):869-873. doi: 10.15036/arerugi.68.869.
The two biologic therapies, anti-IgE (omalizumab) and anti-IL-5 antibodies (mepolizumab), are used in the treatment of severe pediatric asthma. We present here a case study of a 13-year-old girl with severe asthma who switched from omalizumab to mepolizumab therapy and achieved good control over her asthma. The patient was diagnosed with asthma at one year of age and presented with poor disease control, even while taking high doses of inhaled corticosteroids (ICS). As such, she was considered to have severe persistent asthma. At 10 years old, she began omalizumab therapy which improved asthma control. However, after two years of this therapy, she manifested frequent acute exacerbations. At 12 years old, she switched to mepolizumab and has since maintained good control of asthma. Additionally, total serum IgE levels and peripheral eosinophil counts decreased. As the underlying mechanisms of omalizumab and mepolizumab therapy are distinct, it is recommended to use either one if the other proves ineffective.
两种生物疗法，抗IgE（奥马珠单抗）和抗IL-5抗体（美泊利单抗），用于治疗重度小儿哮喘。我们在此展示一个病例研究，一名13岁重度哮喘女孩从奥马珠单抗转换为美泊利单抗治疗，并实现了对哮喘的良好控制。该患者1岁时被诊断为哮喘，即使服用高剂量吸入性糖皮质激素（ICS），病情控制仍不佳。因此，她被认为患有重度持续性哮喘。10岁时，她开始使用奥马珠单抗治疗，哮喘控制情况有所改善。然而，经过两年这种治疗后，她频繁出现急性加重。12岁时，她转换为美泊利单抗治疗，此后哮喘一直保持良好控制。此外，血清总IgE水平和外周嗜酸性粒细胞计数下降。由于奥马珠单抗和美泊利单抗治疗的潜在机制不同，如果另一种药物证明无效，建议使用其中任何一种。
