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关于生物制剂在儿童哮喘治疗中应用的未解决问题。

Unanswered questions on the use of biologics in pediatric asthma.

作者信息

Nieto Antonio, El-Sayed Zeinab A, Gómez René Maximiliano, Hossny Elham, Jiu-Yao Wang, Kalayci Ömer, Morais-Almeida Mário, Phipatanakul Wanda, Pitrez Paulo Marcio, Pozo Beltrán César Fireth, Xepapadaki Paraskevi, Papadopoulos Nikolaos G

机构信息

Pediatric Pulmonology & Allergy Unit. Health Research Institute. Children's Hospital La Fe, Valencia, Spain.

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.

出版信息

World Allergy Organ J. 2023 Nov 3;16(11):100837. doi: 10.1016/j.waojou.2023.100837. eCollection 2023 Nov.

Abstract

The emergence of biologic therapies for the management of asthma has been a revolutionary change in our capacity to manage this disease. Since the launch of omalizumab, several other biologics have been marketed or are close to being marketed, suggesting that a plethora of monoclonal antibodies can be expected in the coming years. This will facilitate the transition to the paradigm of personalized medicine, but on the other hand will decisively further complicate the choice of the most appropriate treatment, in the absence of reliable enough biological markers. For these reasons, along with the relatively short time of use with these treatments, there are recurrently arising questions for which there are not even moderately documented answers, and for which the only solution must be based, with all reservations, on the combination of indirect evidence and expertise. In this paper, we attempt to address such questions, providing relevant commentaries and considering the whole width of the evidence base.

摘要

生物疗法用于哮喘管理的出现,是我们在该疾病管理能力方面的一项革命性变革。自奥马珠单抗推出以来,其他几种生物制剂已上市或即将上市,这表明在未来几年有望出现大量单克隆抗体。这将有助于向个性化医疗模式转变,但另一方面,在缺乏足够可靠的生物标志物的情况下,将决定性地使最合适治疗方案的选择进一步复杂化。由于这些原因,再加上这些治疗方法的使用时间相对较短,经常会出现一些问题,甚至没有适度记录的答案,而唯一的解决办法必须在有所保留的情况下,基于间接证据和专业知识的结合。在本文中,我们试图解决这些问题,提供相关评论并考虑整个证据基础的广度。

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