Talwar Deepak, Yadav Manoj, Maturu Nagarjuna, Sharma Rahul, Meshram Priti, Das Soumya
Pulmonology and Sleep Medicine, Metro Hospitals and Heart Institute, Noida, Uttar Pradesh, 201301, India.
Pulmonology, Kailash Hospital, Centre for Respiratory Disease, Vadodara, Gujrat, 390007, India.
F1000Res. 2023 Sep 27;12:1225. doi: 10.12688/f1000research.132704.1. eCollection 2023.
Severe eosinophilic asthma (SEA), one of the phenotypes of asthma that is characterized by elevated blood eosinophil counts, is a common cause of uncontrolled asthma. Patients with SEA often experience severe persistent symptoms and have frequent exacerbations despite optimal inhaler therapy. They also have poor lung function and quality of life (QoL). Benralizumab (Fasenra), a monoclonal antibody, has been approved for managing cases of SEA. This series of six cases, the first of its kind from India, aims to add to the real-world evidence of benralizumab in India. Benralizumab 30 mg (once in four weeks for the first three doses followed by a dose every eight weeks for two years) was administered in six patients with symptoms of cough, breathlessness on exertion, and wheezing, diagnosed with SEA. The following were the endpoints assessed: (i) overlap between high immunoglobulin E (IgE) and eosinophilic asthma; (ii) reduction of exacerbations; (iii) withdrawal of oral corticosteroids; and (iv) improvement in lung function and QoL. In all cases, management with benralizumab resulted in optimal clinical and functional improvement, a decline in systemic steroid use, and improved QoL. The cases presented here are the first of their kind in the Indian asthmatic population with all SEA patients demonstrating significant improvement in symptoms with the use of benralizumab.
重度嗜酸性粒细胞性哮喘(SEA)是哮喘的一种表型,其特征为血液嗜酸性粒细胞计数升高,是哮喘控制不佳的常见原因。SEA患者常经历严重的持续性症状,尽管接受了最佳的吸入治疗,仍频繁发作。他们的肺功能和生活质量(QoL)也较差。贝那利珠单抗(法尼拉),一种单克隆抗体,已被批准用于治疗SEA病例。这一系列6例病例是印度首例此类病例,旨在增加贝那利珠单抗在印度的真实世界证据。对6例诊断为SEA、有咳嗽、劳力性呼吸困难和喘息症状的患者给予30mg贝那利珠单抗(前3剂每4周1次,随后2年每8周1剂)。评估的终点如下:(i)高免疫球蛋白E(IgE)与嗜酸性粒细胞性哮喘之间的重叠;(ii)发作次数减少;(iii)口服糖皮质激素的停用;以及(iv)肺功能和QoL的改善。在所有病例中,使用贝那利珠单抗治疗均带来了最佳的临床和功能改善、全身类固醇使用量的下降以及QoL的改善。这里展示的病例是印度哮喘患者中的首例此类病例,所有SEA患者使用贝那利珠单抗后症状均有显著改善。