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生物制剂在儿童哮喘管理中的作用

The Role of Biologics in the Management of Asthma in the Pediatric Patient.

作者信息

Morris Taylor S, Autry Elizabeth B, Kuhn Robert J

出版信息

J Pediatr Pharmacol Ther. 2021;26(5):427-436. doi: 10.5863/1551-6776-26.5.427. Epub 2021 Jun 28.

Abstract

The management of pediatric patients with asthma continues to be a major health issue. For many patients, traditional therapies have been very effective, but for a large number of patients asthma remains poorly controlled. This leads to significant morbidity and impairment to quality of life. Recently, several new biologics, as well as new dosage forms of combination inhaled drugs, have been made available for use adding to the armamentarium of therapy for specific asthma phenotypes. Biologics have shown promise in the more difficult to manage asthma patient. Approved in children, omalizumab, an anti-immunoglobulin E (anti-IgE) antibody, has been available for several years. New agents, like mepolizumab and benralizumab, directed against interleukin (IL) 5, have indications for children >6 and >12 years of age, respectively. Dupilumab, an IL-4- and IL-13-directed antibody, has been studied as well in eosinophilic asthma, with positive results. A thorough understanding of the clinical data of these agents is key, as they may greatly improve the quality of life in children with difficult-to-manage asthma.

摘要

小儿哮喘的管理仍然是一个重大的健康问题。对许多患者而言,传统疗法非常有效,但仍有大量患者的哮喘控制不佳。这会导致严重的发病率并损害生活质量。最近,几种新的生物制剂以及联合吸入药物的新剂型已可供使用,增加了针对特定哮喘表型的治疗手段。生物制剂在更难管理的哮喘患者中显示出前景。抗免疫球蛋白E(抗IgE)抗体奥马珠单抗已在儿童中获批数年。针对白细胞介素(IL)-5的新药物,如美泊利单抗和贝那利珠单抗,分别适用于6岁以上和12岁以上的儿童。针对IL-4和IL-13的抗体度普利尤单抗也已在嗜酸性粒细胞性哮喘中进行了研究,结果呈阳性。全面了解这些药物的临床数据至关重要,因为它们可能极大地改善难治性哮喘患儿的生活质量。

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Curr Opin Pediatr. 2018 Jun;30(3):366-371. doi: 10.1097/MOP.0000000000000614.
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Oral Glucocorticoid-Sparing Effect of Benralizumab in Severe Asthma.贝那鲁肽在重症哮喘中的糖皮质激素节省作用。
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