Bagnasco Diego, Bondi Benedetta, Caminati Marco, Nicola Stefania, Pini Laura, Milanese Manlio, Brussino Luisa, Senna Gianenrico, Canonica Giorgio Walter, Braido Fulvio
Respiratory and Allergy Clinic, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Department of Internal Medicine (DIMI), University of Genoa, 16132 Genoa, Italy.
Biomedicines. 2024 Apr 26;12(5):960. doi: 10.3390/biomedicines12050960.
In its severe form, where possible, asthma is treated using biological drugs in order to reduce, as much as possible, the use of systemic steroids. Mepolizumab is effective for severe asthma based on key outcomes such as exacerbation and steroid dependence. Its efficacy in terms of the criteria for clinical remission in the short and long term has become of interest.
We aimed to evaluate the effect of mepolizumab in the achievement of clinical remission after 3 years of administration.
In this study, 71 patients who continued mepolizumab for 3 years were assessed for clinical remission according to six different published sets of remission criteria.
According to the criteria, 39-52% of patients experienced complete remission in the first year, increasing to 51-73% at 3 years. By classifying patients according to partial and complete remission criteria, proposed by the SANI, we observe 22% of patients in partial remission at one year, achieving complete remission after three years. The baseline factors associated with earlier remission were a higher FEV1, if we consider classifications requiring an FEV1 ≥ 80%, a low OCS dose, and low FeNO levels, in the patients requiring FEV1 stabilization.
Clinical remission is possible for patients treated with mepolizumab. The observations at three years compared with the first year indicated that the factors negatively affecting remission delayed rather than prevented it. Earlier treatment could increase the chances of remission.
在重症哮喘患者中，若条件允许，会使用生物药物进行治疗，以尽可能减少全身性激素的使用。美泊利珠单抗对重症哮喘有效，基于如病情加重和激素依赖等关键指标。其在短期和长期临床缓解标准方面的疗效已受到关注。
我们旨在评估美泊利珠单抗给药3年后实现临床缓解的效果。
在本研究中，根据6种不同公布的缓解标准，对71例持续使用美泊利珠单抗3年的患者进行临床缓解评估。
根据标准，39%至52%的患者在第一年实现完全缓解，3年后增至51%至73%。根据SANI提出的部分缓解和完全缓解标准对患者进行分类，我们观察到22%的患者在1年时处于部分缓解状态，3年后实现完全缓解。在需要稳定FEV1的患者中，与较早缓解相关的基线因素是较高的FEV1（如果考虑FEV1≥80%的分类）、低OCS剂量和低FeNO水平。
接受美泊利珠单抗治疗的患者有可能实现临床缓解。3年时与第1年的观察结果表明，对缓解产生负面影响的因素会延迟而非阻止缓解。早期治疗可能会增加缓解的机会。
