生物制剂治疗囊性纤维化患者变应性支气管肺曲霉病的系统评价。
Biologic drugs in treating allergic bronchopulmonary aspergillosis in patients with cystic fibrosis: a systematic review.
机构信息
Dept of Clinical and Experimental Medicine, University of Catania, Catania, Italy
Pediatric Unit, Dept of Human and Pediatric Pathology "Gaetano Barresi", University of Messina, Messina, Italy.
出版信息
Eur Respir Rev. 2022 Jul 27;31(165). doi: 10.1183/16000617.0011-2022. Print 2022 Sep 30.
BACKGROUND
is a common saprophytic fungus causing allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (CF). The recommended first-line treatment for ABPA is oral steroids, followed by antifungal therapy. However, both treatments are not free from adverse effects; thus, efforts are being made to identify new drugs showing the same effectiveness but with fewer or no side-effects. Therein, biologic drugs have been significantly implemented in clinical practice in treating ABPA in patients with CF.
OBJECTIVE
To systematically review the available literature, providing evidence for the administration of biologic drugs as a new potential treatment of ABPA in both the paediatric and adult populations with CF.
METHODS
A systematic review of the literature published between January 2007 and July 2021 was performed, using a protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42021270932).
RESULTS
A total of 21 studies focusing on the use of biologics in treating ABPA in CF patients was included. We highlighted a paucity of data providing evidence for biologic drug use in ABPA.
CONCLUSION
Scientific evidence is insufficient to support firm conclusions and randomised clinical trials are urgently required to investigate the efficacy and safety of biologics for ABPA in CF patients.
背景
烟曲霉是一种常见的腐生真菌，可引起囊性纤维化 (CF) 患者的变应性支气管肺曲霉病 (ABPA)。ABPA 的推荐一线治疗是口服类固醇，随后进行抗真菌治疗。然而，这两种治疗方法都有不良反应；因此，人们正在努力寻找具有相同疗效但副作用较少或没有副作用的新药。在这方面，生物药物已在 CF 患者 ABPA 的临床实践中得到了显著应用。
目的
系统综述现有文献，为生物药物作为治疗 CF 患者 ABPA 的新潜在治疗方法提供证据，涵盖儿科和成人患者。
方法
对 2007 年 1 月至 2021 年 7 月期间发表的文献进行系统综述，使用国际前瞻性系统评价注册中心 (PROSPERO CRD42021270932) 登记的方案。
结果
共纳入 21 项研究，重点关注生物制剂在 CF 患者 ABPA 治疗中的应用。我们发现，提供生物药物治疗 ABPA 证据的数据很少。
结论
科学证据不足以支持明确的结论，迫切需要随机临床试验来研究生物制剂在 CF 患者 ABPA 中的疗效和安全性。
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