摘要
目的评价度普利尤单抗治疗中重度哮喘的有效性和安全性。方法采用回顾性研究方法,选择2021年5月至2022年4月在北京朝阳医院呼吸科门诊就诊的中重度哮喘患者。研究组采用度普利尤单抗治疗,对照组采用中高剂量的吸入性糖皮质激素(inhaled corticosteroids,ICS)和长效β_(2)受体激动剂(long acting betaagonist,LABA)治疗方案。采用配对t检验或曼–惠特尼U检验比较治疗前后患者的哮喘控制测试(Asthma Control Test,ACT)评分、年急性加重次数、2型炎症标志物、血总IgE及肺功能指标的差异,记录治疗过程中的不良反应。结果共纳入47例中重度哮喘患者,经临床评估采用度普利尤单抗治疗17例(研究组)、中高剂量ICS/LABA治疗30例(对照组)。度普利尤单抗治疗后第12个月,患者ACT评分和肺功能各项指标均明显升高,而呼出气一氧化氮、总IgE、血嗜酸性粒细胞计数、血嗜碱性粒细胞计数及年急性加重次数明显下降,相较治疗前具有显著性差异(P<0.05)。7例基线时添加口服糖皮质激素的患者在度普利尤单抗治疗期间剂量逐渐减少至最终停药。不良反应均为轻度,包括4例注射部位肿痛、2例皮肤瘙痒、1例红斑、1例乏力,均自行缓解;1例带状疱疹经对症治疗后痊愈。结论度普利尤单抗治疗中重度哮喘疗效明显,且具有良好安全性。
Objective To evaluate the efficacy and safety of dupilumab in the treatment of moderate-to-severe asthma.Methods A retrospective study was conducted among patients with moderate-to-severe asthma who were treated with dupilumab and inhaled corticosteroids(ICS)combined with long acting beta-agonist(LABA)in Department of Respiratory,Beijing Chao-yang Hospital from May,2021 to April,2022.Paired t-test or Mann-Whitney U test was applied to compare the Asthma Control Test(ACT)scores,number of acute exacerbations per year,type 2 inflammatory biomarkers,blood total IgE and results of pulmonary function tests,including forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),FEV_(1) as percentage of predicted(FEV_(1)%pred),FEV_(1)/FVC,peak expiratory flow(PEF),maximal expiratory flows(MEF)at 75%(MEF75),50%(MEF50)and 25%(MEF25)of the vital capacity PEF,and maximal mid-expiratory flow(MMEF)or FEF _(25%-75% ),at the end of follow-up with those before treatment.Adverse reactions were recorded during the treatment.Results A total of 47 patients with moderate-to-severe asthma were included in the study,among them 17 and 30 received treatment with dupilumab or ICS/LABA.At the time of 12 months after treatment with dupilumab,the patients'ACT score and pulmonary function tests were significantly increased compared with those at the baseline.In contrast,patients'fractional exhaled nitric oxide(FeNO),blood total IgE,blood basophil counts and annual acute exacerbations were significantly decreased in comparison with those at the baseline.The doses of oral corticosteroids added by 7 patients at the baseline was gradually reduced and finally discontinued after treatment of dupilumab.There were 4,2,1 and 1 patients developed injection site reaction,pruritus,erythema and fatigue,respectively,which were mild and recovered without treatment.There was no serious adverse reaction observed,and only 1 case developed herpes zoster which was recovered after treatment.Conclusion Dupilumab shows marked efficacy in the treatment of moderate-to-severe asthma with favorable safety.
作者
王雯
郭越
李洁莹
王斐然
WANG Wen;GUO Yue;LI Jieying;WANG Feiran(Department of Respiratory and Critical Care Medicine,Beijing Institute of Respiratory Medicine,and Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2023年第10期685-691,共7页
Chinese Journal of Respiratory and Critical Care Medicine
作者简介
通信作者:王雯,Email:wangw_cyhospital@163.com
