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巴西重症哮喘登记处患者的基线特征:REBRAG研究。

Baseline characteristics of patients from the Brazilian Severe Asthma Registry: the REBRAG study.

作者信息

Pitrez Paulo Marcio, Chong-Silva Débora Carla, Serpa Faradiba Sarquis, Souza-Machado Adelmir, Rubin Adalberto Sperb, Cardoso Amanda da Rocha Oliveira, Toro Adyléia Aparecida Dalbo Contrera, Lasmar Laura Maria de Lima Belizario Facury, Blanco Daniela Cavalet, Monte Luciana de Freitas Velloso, Lima Marina Andrade, Romaldini José Gustavo Barian, Silva Eduardo Costa de Freitas, Ferreira Kamila Ticiana Dias, Cruz Filho Alvaro Augusto Souza da, Pizzichini Marcia Margaret Menezes

机构信息

. Hospital Santa Casa de Porto Alegre, Pavilhão Pereira Filho, Porto Alegre (RS) Brasil.

. Complexo Hospital de Clínicas da Universidade Federal do Paraná, Curitiba (PR) Brasil.

出版信息

J Bras Pneumol. 2025 Sep 8;51(3):e20240427. doi: 10.36416/1806-3756/e20240427. eCollection 2025.

Abstract

OBJECTIVE

To describe the impact of severe asthma in a real-life cohort in Brazil, reporting on baseline clinical characteristics, access to treatment, and clinical remission under treatment with biologics.

METHODS

Severe asthma patients > 6 years of age were recruited from 23 centers in Brazil. Data on clinical characteristics, lung function, biomarkers, prescribed therapies, and clinical remission under treatment were collected at the baseline visit.

RESULTS

A total of 417 patients were recruited. Of the 162 adult patients, 71% had a history of hospitalization, with 31% having experienced more than two severe exacerbations in the last 12 months and 6% having experienced cardiopulmonary arrest. Allergic and eosinophilic phenotypes were the most common phenotypes in all age groups, with the T2-low phenotype being observed in 10% of the pediatric patients and in 20% of the adult patients. Only 10% of the adult patients and 1% of the pediatric patients were receiving maintenance oral corticosteroids, whereas 41% of the adult patients were under treatment with biologics, with clinical remission being achieved in 20%.

CONCLUSIONS

Severe asthma in Brazil still results in a high disease burden, with less than half of the patients receiving treatment with biologics and clinical remission being achieved in a subgroup of patients treated with biologics for more than 12 months. Achieving disease control remains a major clinical and health care challenge, requiring further actions from specialists and health care providers, as well as additional studies.

摘要

目的

描述重度哮喘在巴西一个真实队列中的影响,报告基线临床特征、治疗可及性以及使用生物制剂治疗后的临床缓解情况。

方法

从巴西23个中心招募6岁以上的重度哮喘患者。在基线访视时收集临床特征、肺功能、生物标志物、规定治疗方案以及治疗期间临床缓解情况的数据。

结果

共招募了417例患者。在162例成年患者中,71%有住院史,31%在过去12个月内经历过两次以上严重加重,6%经历过心肺骤停。过敏和嗜酸性粒细胞表型在所有年龄组中最为常见,10%的儿科患者和20%的成年患者表现为T2低表型。只有10%的成年患者和1%的儿科患者正在接受维持性口服糖皮质激素治疗,而41%的成年患者正在接受生物制剂治疗,其中20%实现了临床缓解。

结论

巴西的重度哮喘仍然导致较高的疾病负担,接受生物制剂治疗的患者不到一半,且在接受生物制剂治疗超过12个月的亚组患者中实现了临床缓解。实现疾病控制仍然是一项重大的临床和医疗挑战,需要专家和医疗服务提供者采取进一步行动,以及开展更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8426/12401096/87a88f5e3dea/1806-3756-jbpneu-51-03-e20240427-gf1.jpg

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