Kai Yoshiro, Suzuki Kentaro, Kataoka Ryosuke, Sato Ichiro, Tamaki Shinji, Muro Shigeo
Department of Respiratory Medicine Minami-Nara General Medical Center Yoshino-gun Japan.
Department of Respiratory Medicine Nara Medical University Kashihara Japan.
Respirol Case Rep. 2024 Feb 27;12(3):e01311. doi: 10.1002/rcr2.1311. eCollection 2024 Mar.
Severe asthma affects approximately 5%-10% of patients with asthma. Herein, we describe a case of non-type 2 asthma that progressively worsened over the years. An 80-year-old woman was diagnosed with asthma 11 years back. She experienced repeated exacerbations requiring treatment with systemic corticosteroid despite therapy with medications including high-dose inhaled corticosteroids/long-acting beta-agonists plus long-acting muscarinic antagonist. The patient presented with non-eosinophilic asthma. Therefore, the patient was initially treated with bronchial thermoplasty, which was effective for 1 year only. Treatment with bronchial thermoplasty, benralizumab, dupilumab, and mepolizumab was ineffective. The fourth treatment, which included tezepelumab, was initiated. The patient's symptoms and quality of life improved significantly. This is the first case of a patient who did not respond to sequential bronchial thermoplasty, benralizumab, dupilumab, and mepolizumab but who presented with good clinical response to tezepelumab. Therefore, tezepelumab may be useful for patients with non-type 2 asthma.
重度哮喘影响约5%-10%的哮喘患者。在此，我们描述一例非2型哮喘病例，该病例多年来病情逐渐恶化。一名80岁女性11年前被诊断为哮喘。尽管使用了包括高剂量吸入性糖皮质激素/长效β受体激动剂加长效毒蕈碱拮抗剂在内的药物治疗，但她仍反复出现加重，需要全身使用糖皮质激素治疗。该患者表现为非嗜酸性粒细胞性哮喘。因此，患者最初接受了支气管热成形术治疗，仅在1年内有效。支气管热成形术、贝那利珠单抗、度普利尤单抗和美泊利珠单抗治疗均无效。开始了包括tezepelumab在内的第四次治疗。患者的症状和生活质量显著改善。这是首例对序贯支气管热成形术、贝那利珠单抗、度普利尤单抗和美泊利珠单抗均无反应，但对tezepelumab有良好临床反应的患者。因此，tezepelumab可能对非2型哮喘患者有用。
