Bergmann Karl-Christian, Oestmann Jörg-Wilhelm, Bousquet Jean, Zuberbier Torsten
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Allergology and Immunology, Berlin, Germany.
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
World Allergy Organ J. 2022 Jul 31;15(8):100669. doi: 10.1016/j.waojou.2022.100669. eCollection 2022 Aug.
We report a case of severe uncontrolled allergic and eosinophilic asthma in which omalizumab had led to a fast remission. After 18 months, mepolizumab was added to omalizumab because of increased blood eosinophils and a deterioration of asthma control. Asthma was then under control for the next 18 months. Discontinuation of mepolizumab in the ensuing 6 months led to a decrease in asthma control and an increased eosinophilia. The introduction of benralizumab resulted in an immediate increase of lung function, asthma control test (ACT), and symptom relief. Before the introduction of biologics, the patient was on the list for transplantation due to respiratory insufficiency. High-resolution CT scans before and after biologic therapy demonstrated a reduction of bronchial wall thickening and mucous plugging as well as an increase in bronchial caliber. The patient did therefore not need a transplant. We conclude that the dual use of biologics may be efficient in some cases of severe asthma.
我们报告了一例严重的难治性过敏性和嗜酸性粒细胞性哮喘病例,其中奥马珠单抗导致了快速缓解。18个月后,由于血液嗜酸性粒细胞增多和哮喘控制恶化,在奥马珠单抗的基础上加用了美泊利单抗。此后哮喘在接下来的18个月里得到了控制。在随后的6个月中停用美泊利单抗导致哮喘控制下降和嗜酸性粒细胞增多。贝那利珠单抗的引入导致肺功能、哮喘控制测试(ACT)立即改善以及症状缓解。在使用生物制剂之前,该患者因呼吸功能不全而在移植名单上。生物治疗前后的高分辨率CT扫描显示支气管壁增厚和黏液嵌塞减少,以及支气管管径增加。因此,该患者不需要进行移植。我们得出结论,在某些严重哮喘病例中,联合使用生物制剂可能是有效的。