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重度哮喘伴鼻息肉患者对生物制剂的实际反应:来自比利时重度哮喘登记处的见解

Real-Life Response to Biologics in Severe Asthma with Nasal Polyposis: Insights from the Belgian Severe Asthma Registry.

作者信息

Demolder Femke, Vanderhelst Eef, Verbanck Sylvia, Schleich Florence, Louis Renaud, Brusselle Guy, Sohy Carine, Michils Alain, Peché Rudi, Pilette Charles, Hanon Shane

机构信息

Respiratory Division, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium.

Respiratory Medicine, CHU of Liège, University of Liège, GIGA I3, 4000, Liège, Belgium.

出版信息

Lung. 2024 Aug;202(4):441-448. doi: 10.1007/s00408-024-00715-0. Epub 2024 Jul 15.

DOI:10.1007/s00408-024-00715-0
PMID:39007944
Abstract

BACKGROUND

Nasal polyposis (NP) is a comorbidity of type 2 severe asthma (SA) which could influence response to SA biologics.

METHODS

We evaluated (super-) response in SA patients with (NP +) and without NP (NP-) enrolled in the Belgian Severe Asthma Registry (BSAR).

RESULTS

914 patients, of whom 31% NP + , were included. At enrollment, NP + patients had higher annual exacerbation rates, higher number of emergency room visits and more elevated type 2 biomarkers. In the longitudinal subanalysis of 104 patients, both groups had significant and similar asthma responses to asthma biologics, except for a greater increase in FEV in the NP + group. Super-response was achieved in 33 patients (32%), irrespective of NP status or type of biologic.

CONCLUSION

In conclusion, both NP + and NP - patients had positive treatment responses, with some able to achieve super-response. In SA patients with NP, a greater FEV improvement as compared to SA patients without NP was observed.

摘要

背景

鼻息肉病(NP)是2型重度哮喘(SA)的一种合并症,可能影响对SA生物制剂的反应。

方法

我们评估了比利时重度哮喘登记处(BSAR)登记的伴有NP(NP+)和不伴有NP(NP-)的SA患者的(超)反应。

结果

纳入了914例患者,其中31%为NP+。入组时,NP+患者的年加重率更高、急诊就诊次数更多且2型生物标志物水平更高。在对104例患者的纵向亚分析中,两组对哮喘生物制剂的哮喘反应均显著且相似,但NP+组的第一秒用力呼气容积(FEV)增加幅度更大。33例患者(32%)实现了超反应,与NP状态或生物制剂类型无关。

结论

总之,NP+和NP-患者均有积极的治疗反应,部分患者能够实现超反应。在伴有NP的SA患者中,与不伴有NP的SA患者相比,观察到FEV改善更明显。

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