Pérez-de Llano Luis, Bonilla Mª Gema, Luzon Elisa, Ramos-Lima Francisco, Miralles Juan Carlos
Pulmonology Department, Lucus Augusti University Hospital, Lugo, Spain.
Rheumatology Department, La Paz University Hospital, Madrid, Spain.
Open Respir Arch. 2025 Feb 28;7(2):100418. doi: 10.1016/j.opresp.2025.100418. eCollection 2025 Apr-Jun.
Theoretically, an early intervention with biologics in severe asthma (SA) patients may attenuate inflammatory processes and potentially halt disease progression and remodeling. Changing the approach to a more preventive one could alter the course of the disease, avoid its progression, and improve the likelihood of achieving clinical remission. The aims of this study were to gather scientific evidence on this topic, to draw a parallel between SA and rheumathoid arthritis (RA) and to analyze the potential benefits of establishing early treatment in SA.
A systematic scoping review, conducted in accordance with the methodological guidance of the Arksey and O'Malley framework and focusing on early treatment intervention with biological drugs in SA and RA is presented.
Evidence supports the early intervention with biologics in RA to improve outcomes. Evidence regarding early intervention with biologics in SA is scarce. To date, the literature reviewed suggests that better clinical condition of the patient and more preserved lung function at the onset of biological treatment, together with a shorter duration of asthma, are associated with better response to biologics.
Data suggests that the more preventive approach may lead to improved results. The scarcity of scientific evidence highlights the importance of pursuing this line of research.
从理论上讲,对重度哮喘(SA)患者早期使用生物制剂进行干预,可能会减轻炎症过程,并有可能阻止疾病进展和重塑。将治疗方法转变为更具预防性的方法可能会改变疾病进程,避免其进展,并提高实现临床缓解的可能性。本研究的目的是收集关于该主题的科学证据,比较SA和类风湿性关节炎(RA),并分析在SA中建立早期治疗的潜在益处。
本文呈现了一项系统的范围综述,该综述按照阿克西和奥马利框架的方法学指导进行,重点关注生物药物在SA和RA中的早期治疗干预。
有证据支持在RA中早期使用生物制剂可改善预后。关于在SA中早期使用生物制剂进行干预的证据很少。迄今为止,所审查的文献表明,患者在开始生物治疗时临床状况较好、肺功能保留更多以及哮喘病程较短,与对生物制剂的反应较好相关。
数据表明,更具预防性的方法可能会带来更好的结果。科学证据的匮乏凸显了开展这一研究方向的重要性。