Başa Akdoğan Buket, Aksu Kurtuluş, Koca Kalkan İlkay, Köycü Buhari Gözde, Özdedeoğlu Özlem, Ateş Hale, Öner Erkekol Ferda
Clinic of Immunology and Allergy, Health Sciences University Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Türkiye.
Tuberk Toraks. 2024 Mar;72(1):71-81. doi: 10.5578/tt.202401795.
Recurrences occur when corticosteroid therapy is discontinued or reduced during the treatment of chronic eosinophilic pneumonia (CEP). The probability of recurrence is once in 50% of patients and twice or more in 25%. In such instances, new treatment options are deemed necessary. This study aims to assess the efficacy of omalizumab treatment as a steroid-sparing drug in patients with CEP.
The clinical features of patients treated with omalizumab for recurrent CEP were evaluated retrospectively before and after treatment. All data from patients and diagnoses were reviewed. The effects of treatment on recurrence rate, oral corticosteroid (OCS) use and lung functions, peripheral eosinophil values, and symptom scores were evaluated. Radiological regression was also evaluated.
In the final analysis, we included ten patients with a median follow-up of 22 months after initiation of omalizumab. During this follow-up period, the results were associated with a significant reduction in the number of asthma attacks per year, the number of CEP relapses, the rate of hospitalization, the amount of corticosteroids consumed daily, and the total corticosteroid dose. In addition, improvement was observed in the symptom scores and lung functions of the patients. Systemic steroids were completely discontinued in two patients receiving omalizumab treatment. In other patients, the mean steroid dose was reduced by 77.2 percent in the first year of omalizumab treatment and 82 percent in the second year, respectively. Nevertheless, there was no elevation in peripheral eosinophil count, and radiological regression was observed.
Omalizumab can be an effective treatment for CEP and can be used as a steroid-sparing agent.
在慢性嗜酸性粒细胞性肺炎（CEP）治疗期间，停用或减少皮质类固醇治疗时会出现复发情况。复发概率为50%的患者会复发一次，25%的患者会复发两次或更多次。在这种情况下，需要新的治疗选择。本研究旨在评估奥马珠单抗治疗作为CEP患者的类固醇节省药物的疗效。
回顾性评估接受奥马珠单抗治疗复发性CEP患者治疗前后的临床特征。对患者的所有数据和诊断进行了审查。评估了治疗对复发率、口服皮质类固醇（OCS）使用情况、肺功能、外周嗜酸性粒细胞值和症状评分的影响。还评估了影像学消退情况。
在最终分析中，我们纳入了10例患者，在开始使用奥马珠单抗后中位随访22个月。在此随访期间，结果显示每年哮喘发作次数、CEP复发次数、住院率、每日消耗的皮质类固醇量和皮质类固醇总剂量均显著减少。此外，观察到患者的症状评分和肺功能有所改善。两名接受奥马珠单抗治疗的患者完全停用了全身类固醇。在其他患者中，奥马珠单抗治疗第一年平均类固醇剂量减少了77.2%，第二年减少了82%。然而，外周嗜酸性粒细胞计数没有升高，并且观察到影像学消退。
奥马珠单抗可以是CEP的有效治疗方法，并且可以用作类固醇节省剂。
