Caminati M, Morais-Almeida M, Bleecker E, Ansotegui I, Canonica G W, Bovo C, Senna G
Department of Medicine, University of Verona, Verona, Italy.
Allergy Center, CUF Descobertas Hospital, CUF Academic and Research Medical Center, Lisbon, Portugal.
World Allergy Organ J. 2021 Jan 6;14(2):100502. doi: 10.1016/j.waojou.2020.100502. eCollection 2021 Feb.
Biologics for severe asthma can significantly impact on the burden of disease and also have the potential to reduce asthma mortality. By reviewing the literature and contacting the pharmaceutical companies, the present paper aims at providing a worldwide snapshot of biologic drugs availability, related with the trend of asthma mortality rate, as a marker of the burden of the disease. A decline in the global rate of annual asthma mortality was observed until the 1980s, but overall no further reduction occurred, and the current mortality estimation is 0.19 deaths per 100.000 people. A higher mortality rate has been registered in low and middle-income countries (LMICs), where poor socioeconomic conditions and lack of access to the medical resources are more relevant. The availability of monoclonal antibodies is mainly limited to the developed and high-income countries. Furthermore the overall "asthma management system" in LMICs suffers from a number of restrictions that hamper the widespread availability of biologics besides their costs. The availability of generic drugs in the field of biologics for severe asthma could contribute to facilitate their widespread accessibility. But before that, awareness and expertise regarding severe asthma, and proper tools to assess and manage it, deserve to be shared worldwide. Collaboration projects involving physicians from all the countries through the scientific Academies network and with the support of the Companies active in the field may provide an initial concrete opportunity.
用于重度哮喘的生物制剂可显著影响疾病负担，也有可能降低哮喘死亡率。通过查阅文献并与制药公司联系，本文旨在提供一份全球生物制剂可用性的概况，以及与哮喘死亡率趋势相关的情况，以此作为疾病负担的一个指标。直到20世纪80年代，全球年度哮喘死亡率呈下降趋势，但总体上并未进一步降低，目前的死亡率估计为每10万人中有0.19人死亡。低收入和中等收入国家（LMICs）的死亡率较高，在这些国家，社会经济条件差和缺乏医疗资源的获取更为突出。单克隆抗体的可用性主要限于发达国家和高收入国家。此外，除了成本因素外，低收入和中等收入国家的整体“哮喘管理系统”还存在一些限制，阻碍了生物制剂的广泛供应。用于重度哮喘的生物制剂领域的仿制药的可用性可能有助于促进其广泛可及性。但在此之前，关于重度哮喘的认识和专业知识，以及评估和管理它的适当工具，值得在全球范围内共享。通过科学学术网络并在该领域活跃公司的支持下，涉及所有国家医生的合作项目可能会提供一个初步的具体机会。
