Benralizumab and the integrated management of co-morbid severe eosinophilic asthma with chronic rhinosinusitis with nasal polyps

IF 4.6 2区 医学 Q2 ALLERGY
Joaquim Mullol, Maria D'Amato, Eugenio de Corso, Joseph K. Han, Jody Tversky
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Abstract

Background

Type 2 (T2) inflammation, characterized by blood and airway eosinophilia, underlies severe eosinophilic asthma (SEA) and chronic rhinosinusitis with nasal polyps (CRSwNP). In line with the Global Airways theory, SEA and CRSwNP frequently co-occur, creating a multimorbid phenotype. Separately, SEA and CRSwNP are burdensome: when concomitant, they compound each other, creating a more difficult-to-treat disease with increased complications.

Body

Current management approaches rarely control disease and are associated with substantial side-effects. Several recently developed anti-IL-5 monoclonal antibodies have shown efficacy in treating co-morbid SEA with CRSwNP by targeting T2 inflammation with systemic therapies. Of these, only benralizumab directly targets the IL-5 receptor-α, leading to rapid, sustained, near-complete eosinophil depletion. Analyses in patients with co-morbid SEA with CRSwNP are limited, although data from the ANDHI, XALOC-1, and RANS studies suggest benralizumab can effectively target inflammation underlying co-morbid disease.

Conclusion

Despite progress toward more effective therapies, treatment approaches remain siloed, with SEA and CRSwNP often managed separately. There is a need for the development of multidisciplinary approaches for treating patients with comorbid SEA with CRSwNP.

Abstract Image

贝那利珠单抗与合并严重嗜酸性粒细胞哮喘合并慢性鼻窦炎合并鼻息肉的综合治疗
背景2型(T2)炎症以血液和气道嗜酸性粒细胞增多为特征,是严重嗜酸性粒细胞哮喘(SEA)和慢性鼻窦炎伴鼻息肉(CRSwNP)的基础。与Global Airways理论一致,SEA和CRSwNP经常同时发生,形成多病表型。单独来说,SEA和CRSwNP都是负担沉重的:当它们同时出现时,它们会相互复合,产生一种更难以治疗的疾病,并发症也会增加。目前的治疗方法很少能控制疾病,而且有很大的副作用。最近开发的几种抗il -5单克隆抗体已显示出通过靶向T2炎症和全身治疗治疗CRSwNP合并症SEA的疗效。其中,只有benralizumab直接靶向IL-5受体-α,导致快速、持续、近乎完全的嗜酸性粒细胞耗竭。虽然来自ANDHI、XALOC-1和RANS研究的数据表明,benralizumab可以有效靶向合并症下的炎症,但对合并SEA和CRSwNP患者的分析有限。结论:尽管在更有效的治疗方面取得了进展,但治疗方法仍然是孤立的,SEA和CRSwNP通常是分开处理的。有必要开发多学科方法来治疗合并SEA和CRSwNP的患者。
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来源期刊
Clinical and Translational Allergy
Clinical and Translational Allergy Immunology and Microbiology-Immunology
CiteScore
7.50
自引率
4.50%
发文量
117
审稿时长
12 weeks
期刊介绍: Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
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