Chiner Eusebi, Murcia María, Boira Ignacio, Bernabeu María Ángeles, Esteban Violeta, Martínez-Moragón Eva
Pulmonology Department, University Hospital of Saint John of Alicante, 03550 Alicante, Spain.
Pharmacy Department, University Hospital of Saint John of Alicante, 03550 Alicante, Spain.
J Clin Med. 2024 Jul 20;13(14):4247. doi: 10.3390/jcm13144247.
The objective of this study was to evaluate, the clinical benefit of benralizumab in patients with uncontrolled severe asthma associated with chronic rhinosinusitis with nasal polyposis (CRSwNP). The study included patients with uncontrolled severe asthma associated with CRSwNP who started therapy with benralizumab. Pulmonary function, eosinophilia, IgE, comorbidity, changes in the Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Visual Analogue Scale (VAS), Quality of Life (AQLQ), VAS (obstruction, drip, anosmia, facial pressure), SNOT-22, decrease or withdrawal of steroids and other medication, hospital admissions and emergency visits were analysed. The FEOS scale and EXACTO were employed in the assessment of response. We analyzed 58 patients who completed minimal treatment at 12 months. After treatment with benralizumab, exacerbations were reduced by 82% ( < 0.001), steroid cycles by 84% ( < 0.001), emergencies visit by 83% < 0.001) and admissions by 76% ( < 0.001), improving all the scales for asthma control, ( < 0.001). In terms of lung function, differences were observed in FVC% ( < 0.001), FEV1% ( < 0.001), and FEV1/FVC% (69.5 ± 10 vs. 74 ± 10, < 0.001). In relation to CRSwNP, differences were observed in SNOT-22 (54.66 ± 17 vs. 20.24 ± 9, < 0.001), VAS obstruction (7.91 ± 1 vs. 1.36 ± 1, < 0. 001), VAS drip (7.76 ± 1 vs. 1.38 ± 1, < 0.001), VAS anosmia (7.66 ± 1 vs. 1.38 ± 1, < 0.001) and VAS facial pressure (7.91 ± 1 vs. 1.22 ± 1, < 0.001). The mean FEOS score after treatment was 73 ± 14. A complete response/super response was achieved in 33 patients (57%), good response in 16 (28%) and partial response in 9 (15%). The administration of benralizumab to patients with uncontrolled severe asthma associated with CRSwNP has been demonstrated to improve nasal symptoms, asthma control and lung function. This resulted in a reduction in the need for oral steroids, maintenance and rescue medication, emergency room visits, and hospital admissions, with 57% of patients achieving the clinical remission criteria.
本研究的目的是评估贝那利珠单抗对患有与慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）相关的未控制的重度哮喘患者的临床益处。该研究纳入了开始使用贝那利珠单抗治疗的与CRSwNP相关的未控制的重度哮喘患者。分析了肺功能、嗜酸性粒细胞增多、免疫球蛋白E、合并症、哮喘控制测试（ACT）、哮喘控制问卷（ACQ）、视觉模拟量表（VAS）、生活质量（AQLQ）、VAS（鼻塞、流涕、嗅觉减退、面部压迫感）、鼻窦鼻息肉结局测试-22（SNOT-22）、类固醇和其他药物的减量或停用、住院和急诊就诊情况。采用FEOS量表和EXACTO评估反应情况。我们分析了58例在12个月时完成最低限度治疗的患者。使用贝那利珠单抗治疗后，急性加重减少了82%（P<0.001），类固醇使用周期减少了84%（P<0.001），急诊就诊减少了83%（P<0.001），住院减少了76%（P<0.001），所有哮喘控制量表均得到改善（P<0.001）。在肺功能方面，观察到用力肺活量百分比（FVC%，P<0.001）、第1秒用力呼气容积百分比（FEV1%，P<0.001）和FEV1/FVC%（69.5±10对比74±10，P<0.001）存在差异。关于CRSwNP，观察到SNOT-22（54.66±17对比20.24±9，P<0.001）、VAS鼻塞（7.91±1对比1.36±1，P<0.001）、VAS流涕（7.76±1对比1.38±1，P<0.001）、VAS嗅觉减退（7.66±1对比1.38±1，P<0.001）和VAS面部压迫感（7.91±1对比1.22±1，P<0.001）存在差异。治疗后的平均FEOS评分为73±14。33例患者（57%）达到完全缓解/超反应，16例（28%）达到良好反应，9例（15%）达到部分反应。已证明，对与CRSwNP相关的未控制的重度哮喘患者使用贝那利珠单抗可改善鼻部症状、哮喘控制和肺功能。这导致口服类固醇、维持和急救药物的需求减少，急诊室就诊和住院次数减少，57%的患者达到临床缓解标准。
