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使用美泊利珠单抗实现哮喘临床缓解:以维生素D作为反应预测指标的亚组分析

Achieving clinical remission in asthma with mepolizumab: a subanalysis on vitamin D as a predictor of response.

作者信息

Jha Ravi Shekhar

机构信息

Department of Pulmonology, Fortis Escorts Hospital, Faridabad, India.

出版信息

J Asthma. 2025 Apr;62(4):549-553. doi: 10.1080/02770903.2024.2419435. Epub 2024 Nov 1.

DOI:10.1080/02770903.2024.2419435
PMID:39432687
Abstract

OBJECTIVE

Mepolizumab, an anti-IL-5 monoclonal antibody, has shown promise in reducing exacerbations and steroid dependency in severe eosinophilic asthma. This study aims to evaluate the effectiveness of mepolizumab in achieving clinical remission in asthma over 12 months and explore Vitamin D levels as a predictor of response.

METHOD

We assessed Asthma Control Questionnaire (ACQ) scores, spirometry, number of exacerbations, oral corticosteroid (OCS) use, and inhaled corticosteroid (ICS) use in 32 patients, observing significant clinical improvements. Data were collected 1 year prior to starting mepolizumab and one year after starting mepolizumab. Nasal polyps were not seen in all the patients, and computed tomography of para-nasal sinuses are not available for all the patients, so nasal polyps status are not evaluated to avoid any bias.

RESULT

Our results indicate that 12 patients achieved clinical remission after starting mepolizumab, with a strong correlation between higher Vitamin D levels and positive treatment outcomes. This suggests that optimizing Vitamin D levels could enhance the response to mepolizumab in asthma patients, and help in achieving better asthma control.

CONCLUSION

Mepolizumab is an effective treatment for severe eosinophilic asthma, significantly improving clinical outcomes and reducing corticosteroid use. This study highlights the importance of Vitamin D as a predictor of response to mepolizumab, suggesting that higher Vitamin D levels may enhance treatment efficacy.

摘要

目的

美泊利珠单抗是一种抗白细胞介素-5单克隆抗体,已显示出在减少重度嗜酸性粒细胞性哮喘发作和类固醇依赖方面的前景。本研究旨在评估美泊利珠单抗在12个月内实现哮喘临床缓解的有效性,并探索维生素D水平作为反应预测指标。

方法

我们评估了32例患者的哮喘控制问卷(ACQ)评分、肺功能、发作次数、口服糖皮质激素(OCS)使用情况和吸入糖皮质激素(ICS)使用情况,观察到显著的临床改善。在开始使用美泊利珠单抗前1年和开始使用美泊利珠单抗后1年收集数据。并非所有患者都有鼻息肉,也并非所有患者都能进行鼻窦计算机断层扫描,因此未评估鼻息肉状态以避免任何偏倚。

结果

我们的结果表明,12例患者在开始使用美泊利珠单抗后实现了临床缓解,较高的维生素D水平与积极的治疗结果之间存在强相关性。这表明优化维生素D水平可增强哮喘患者对美泊利珠单抗的反应,并有助于实现更好的哮喘控制。

结论

美泊利珠单抗是重度嗜酸性粒细胞性哮喘的有效治疗方法,可显著改善临床结局并减少糖皮质激素使用。本研究强调了维生素D作为美泊利珠单抗反应预测指标的重要性,表明较高的维生素D水平可能增强治疗效果。

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