Loperfido Antonella, Montuori Claudio, Caminati Marco, Gori Niccolò, D'Auria Leandro Maria, Bellocchi Gianluca, Cavaliere Carlo, Lucidi Daniela, Antonio Moffa, De Corso Eugenio
Otolaryngology Unit, San Camillo Forlanini Hospital, Rome, Italy.
Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy.
Curr Allergy Asthma Rep. 2025 Jul 28;25(1):32. doi: 10.1007/s11882-025-01214-9.
This review evaluates current evidence on tapering strategies for anti-type 2 biologics in chronic inflammatory diseases. Given the need for long-term treatment, optimizing dosage without compromising efficacy is essential for sustainable disease management.
Biologic dose reduction strategies, such as tapering, de-escalation, dose spacing and interval dose prolongation, are increasingly explored in various type 2 inflammatory diseases, particularly in real-life settings. Studies have shown variable outcomes depending on disease type, patient characteristics, and tapering methods. Nineteen studies met inclusion criteria in this systematic review. The evidence supports the feasibility of dose tapering, especially for dupilumab, in maintaining disease control while reducing drug exposure. However, standardized tapering protocols and clear patient selection criteria remain lacking. Further prospective, controlled studies are needed to define optimal, safe, and personalized de-escalation strategies for long-term management of type 2 inflammatory diseases.
本综述评估了目前关于慢性炎症性疾病中抗2型生物制剂减量策略的证据。鉴于长期治疗的必要性，在不影响疗效的情况下优化剂量对于可持续的疾病管理至关重要。
生物制剂剂量减少策略，如逐渐减量、降阶梯、剂量间隔和延长给药间隔，在各种2型炎症性疾病中越来越多地被探索，尤其是在现实生活环境中。研究表明，根据疾病类型、患者特征和减量方法的不同，结果也有所不同。在本系统综述中有19项研究符合纳入标准。证据支持逐渐减量的可行性，尤其是对于度普利尤单抗，在减少药物暴露的同时维持疾病控制。然而，仍然缺乏标准化的减量方案和明确的患者选择标准。需要进一步的前瞻性对照研究来确定用于2型炎症性疾病长期管理的最佳、安全和个性化的降阶梯策略。
