Angelica Tiotiu, Charles Pilette, Diego Bagnasco, Benedetta Bondi, Fulvio Braido, Giuseppe Liistro
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引用次数: 0
Abstract
Background: Different biologics available as add-on treatment for severe asthma (SA) showed modest benefits on lung function parameters but head-to-head comparisons are lacking.
Objective: This study aims to compare the effects of four biologics on lung function parameters (including small airways) at 6 and 12 months of treatment in patients with SA.
Methods: An observational multicenter study was conducted on adults patients with SA naïve to biologics treated by benralizumab, dupilumab, mepolizumab and omalizumab with lung function assessment by spirometry and gas dilution method at baseline (T0), after 6 (T6) and 12 months (T12) of treatment.
Results: One hundred fifty-eight included patients were divided into four groups: 41 patients treated with omalizumab, 41 patients with mepolizumab, 36 patients with benralizumab, and 40 patients with dupilumab. Most lung function parameters were improved after 6 and 12 months of treatment without significant differences between groups except for the changes in the forced expiratory volume in one second in % (ΔFEV1%) (5.8±15.2 vs. 10.3±10.8 vs. 14.3±15.3 vs. 11.8±14.6, p=0.025) and forced vital capacity in % (ΔFVC%) (3.0±15.6 vs. 6.7±14.6 vs. 13.6±14.7 vs. 8.4±14.9, p=0.014) at T6, higher in the group receiving benralizumab. Trends for greater effectiveness of dupilumab in improving small airway dysfunction and benralizumab on distal airway obstruction were noted but the results are not always significant.
Conclusion: All four biologics showed comparable effectiveness in the improvement of lung function parameters after 6 and 12 months of treatment, except the changes of FEV1 and FVC in % at T6 in favor of benralizumab.
背景：作为严重哮喘（SA）附加治疗的不同生物制剂对肺功能参数显示出适度的益处，但缺乏正面比较。目的：本研究旨在比较四种生物制剂对SA患者治疗6个月和12个月时肺功能参数（包括小气道）的影响。方法：对接受benralizumab、dupilumab、mepolizumab和omalizumab治疗的SA成人患者naïve进行多中心观察性研究，在基线（T0）、治疗6个月（T6）和12个月（T12）时，采用肺活量测定法和气体稀释法评估肺功能。结果：158例纳入的患者分为4组：41例使用奥玛珠单抗，41例使用美波珠单抗，36例使用贝那利单抗，40例使用杜匹单抗。治疗6个月和12个月后，除T6时% （ΔFEV1%） 1秒用力呼气量（5.8±15.2 vs. 10.3±10.8 vs. 14.3±15.3 vs. 11.8±14.6,p=0.025）和% （ΔFVC%）用力肺活量（3.0±15.6 vs. 6.7±14.6 vs. 13.6±14.7 vs. 8.4±14.9,p=0.014）的变化外，大多数肺功能参数均得到改善，组间无显著差异。dupilumab在改善小气道功能障碍和benralizumab在远端气道阻塞方面更有效的趋势被注意到，但结果并不总是显著的。结论：在治疗6个月和12个月后，所有四种生物制剂在改善肺功能参数方面均显示出相当的有效性，除了在T6时FEV1和FVC的百分比变化有利于贝纳利珠单抗。
期刊介绍：
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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