Portacci Andrea, Iorillo Ilaria, Quaranta Vitaliano Nicola, Maselli Leonardo, Lulaj Ernesto, Buonamico Enrico, Dragonieri Silvano, Carpagnano Giovanna Elisiana
Institute of Respiratory Disease, Department Translational Biomedicine and Neuroscience, University "Aldo Moro", Bari, Italy.
Respiratory Disease Department, "Di Venere" Hospital, Bari, Italy.
Respir Med. 2023 Oct;217:107348. doi: 10.1016/j.rmed.2023.107348. Epub 2023 Jul 6.
INTRODUCTION: Dupilumab, a fully human anti-interleukin-4/interleukin-13 monoclonal antibody, has shown efficacy in many aspects of Type-2 severe asthma management. Currently, we lack real-life studies addressing the achievment of clinical remission in patients treated with this biologic. MATERIALS AND METHODS: We performed a prospective study enrolling 18 patients with severe asthma treated with Dupilumab. We assessed main clinical, functional and biological severe asthma features at baseline (T0) and after a 1-year course of treatment (T12). Clinical remission was defined at T12 in patients without asthma exacerbations, no oral corticosteroid (OCS) use, ACT ≥ 20 and FEV1 improvement ≥ 100 ml from baseline. RESULTS: Among total population, 38.9% of patients achieved clinical remission at T12. Anti IL-4/IL-13 treatment significantly reduced asthma exacerbations and OCS use in the overall cohort, with a more pronounced ACT improvement in the remission group. Patients achieving clinical remission went through a step down of the inhalation therapy, suspending long-acting anti-muscarinics administration at T12. CONCLUSIONS: Treatment with anti-IL4/IL13 can induce clinical remission in patients with T2 severe asthma.
引言:度普利尤单抗是一种全人源抗白细胞介素-4/白细胞介素-13单克隆抗体,已在重度2型哮喘管理的多个方面显示出疗效。目前,我们缺乏关于接受这种生物制剂治疗的患者实现临床缓解情况的真实世界研究。 材料与方法:我们进行了一项前瞻性研究,纳入了18例接受度普利尤单抗治疗的重度哮喘患者。我们在基线(T0)和经过1年治疗疗程后(T12)评估了重度哮喘的主要临床、功能和生物学特征。T12时,无哮喘发作、未使用口服糖皮质激素(OCS)、ACT≥20且FEV1较基线改善≥100 ml的患者被定义为临床缓解。 结果:在总体人群中,38.9%的患者在T12时实现了临床缓解。抗白细胞介素-4/白细胞介素-13治疗显著减少了整个队列中的哮喘发作和OCS使用,缓解组的ACT改善更为明显。实现临床缓解的患者减少了吸入治疗,在T12时停用了长效抗毒蕈碱药物。 结论:抗白细胞介素-4/白细胞介素-13治疗可诱导重度2型哮喘患者实现临床缓解。
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