Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Matsuwaki Clinic Shinagawa, 6-7-29 Kitashinagawa Shinagawa-ku, Tokyo, 140-0001, Japan.
BMC Pulm Med. 2022 Jun 28;22(1):258. doi: 10.1186/s12890-022-02046-3.
Dupilumab, an anti-IL-4α receptor antibody, is a new treatment for severe or refractory asthma. However, real-world evidence on the efficacy of dupilumab in patients with mild to moderate bronchial asthma is lacking.
We retrospectively evaluated the effects of dupilumab in 62 patients who received dupilumab for eosinophilic sinusitis comorbid with asthma at a single centre in Japan. Type 2 inflammatory markers, ACT, respiratory function tests, and forced oscillation technique (FOT) were analysed before, three months after, and one year after dupilumab administration, mainly in patients with mild to moderate asthma.
FEV1, %FEV1, %FVC, treatment steps for asthma and ACT improved significantly after three months of dupilumab treatment. FeNO was markedly decreased, whereas IgE and eosinophil counts showed no significant changes. Pre- and post-treatment respiratory resistance (Rrs) and respiratory reactance (Xrs) correlated significantly with FEV1. Improvement in %FEV1 was associated with higher FeNO and higher serum IgE before dupilumab treatment.
Dupilumab treatment for sinusitis may improve respiratory functions, asthma symptoms, and asthma treatment reduction, even if the associated bronchial asthma is not severe.
度普利尤单抗是一种抗白细胞介素-4α 受体抗体，是治疗严重或难治性哮喘的新方法。然而，度普利尤单抗在轻度至中度支气管哮喘患者中的疗效的真实世界证据尚缺乏。
我们在日本的一家中心回顾性评估了度普利尤单抗治疗伴哮喘的嗜酸性鼻窦炎的 62 例患者的疗效。在接受度普利尤单抗治疗前、治疗后 3 个月和 1 年后，主要在轻度至中度哮喘患者中分析了 2 型炎症标志物、ACTH、呼吸功能测试和强迫振荡技术（FOT）。
FEV1、FEV1%、FVC%、哮喘治疗步骤和 ACT 在度普利尤单抗治疗 3 个月后显著改善。FeNO 明显降低，而 IgE 和嗜酸性粒细胞计数无明显变化。治疗前和治疗后的呼吸阻力（Rrs）和呼吸电抗（Xrs）与 FEV1 显著相关。FEV1%的改善与度普利尤单抗治疗前更高的 FeNO 和更高的血清 IgE 相关。
即使相关的支气管哮喘不严重，度普利尤单抗治疗鼻窦炎也可能改善呼吸功能、哮喘症状和减少哮喘治疗。
