Windom Allergy, Asthma, and Sinus Specialists, Sarasota, Florida.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida.
Ann Allergy Asthma Immunol. 2021 Dec;127(6):627-637. doi: 10.1016/j.anai.2021.09.009. Epub 2021 Sep 23.
To summarize the therapeutic effects and safety of biologics either approved or in clinical development for asthma, chronic obstructive pulmonary disease, urticaria, nasal polyps, atopic dermatitis, and eosinophilic esophagitis. This review attempts to provide some guidance when choosing among agents.
Recently published articles obtained through PubMed database searches including research articles, review articles, and case reports.
PubMed database searches were conducted using the following keywords: biologics, asthma, COPD, urticaria, atopic dermatitis, food allergy, nasal polyps, and eosinophilic esophagitis.
The approval of omalizumab by the Food and Drug Administration in 2003 for patients with asthma paved the way for the development of multiple biologics for a variety of respiratory and allergic diseases. Agents approved by the Food and Drug Administration include mepolizumab, reslizumab, benralizumab, and dupilumab, and several more are in the late stages of clinical development. Owing to the overlap in the pathogenesis of respiratory and allergic diseases, many of these biologics target multiple respiratory and allergic diseases simultaneously.
The numerous biologic options have made the selection of the best biologic for each patient a potential conundrum for clinicians. Adequate point of care biomarkers to facilitate personalized medical therapy are generally lacking. Furthermore, although clinically effective and generally safe, none of the biologics discussed in this review have induced long-standing disease remission. Nevertheless, these agents have given us the opportunity to treat the most severe patients and to better understand the biology of respiratory and allergic diseases. As knowledgeable physicians, we should embrace and be educated on these novel therapies and the pathways they target.
总结已批准或处于临床开发阶段的生物制剂在哮喘、慢性阻塞性肺疾病、荨麻疹、鼻息肉、特应性皮炎和嗜酸性食管炎治疗中的疗效和安全性。本综述旨在为选择治疗药物提供一些指导。
通过 PubMed 数据库检索，包括研究文章、综述文章和病例报告，获取最近发表的文章。
使用以下关键词在 PubMed 数据库中进行检索：生物制剂、哮喘、COPD、荨麻疹、特应性皮炎、食物过敏、鼻息肉和嗜酸性食管炎。
2003 年，美国食品和药物管理局（FDA）批准奥马珠单抗用于哮喘患者，为多种呼吸道和过敏性疾病的多种生物制剂的开发铺平了道路。FDA 批准的药物包括美泊利单抗、瑞利珠单抗、贝那利珠单抗和度普利尤单抗，还有更多药物处于临床开发的后期阶段。由于呼吸道和过敏性疾病的发病机制重叠，许多这些生物制剂同时针对多种呼吸道和过敏性疾病。
大量的生物制剂选择使得为每位患者选择最佳生物制剂成为临床医生的一个潜在难题。通常缺乏有助于个体化医疗的即时护理生物标志物。此外，尽管这些生物制剂在临床上有效且通常安全，但本文讨论的生物制剂均未诱导长期疾病缓解。尽管如此，这些药物为我们提供了治疗最严重患者的机会，并使我们更好地了解呼吸道和过敏性疾病的生物学特性。作为有知识的医生，我们应该接受并了解这些新疗法及其靶向的途径。
