生物制剂对非甾体抗炎药物引起的胃食管反流病的疗效：从鼻子到支气管的联合气道"。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2024-11-01 DOI:10.1016/j.jaip.2024.09.021

Kathleen M. Buchheit MD , Elke Vandewalle MMed , Hester B.E. Elzinga MD , Sietze Reitsma MD, PhD , Wytske Fokkens MD, PhD , Phillippe Geveart MD, PhD

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引用次数: 0

摘要

非甾体抗炎药加重的呼吸道疾病（NSAID-ERD）是严重慢性鼻炎伴鼻息肉（CRSwNP）、哮喘和环氧化酶 1 抑制剂呼吸道反应的临床三联症，其治疗通常具有挑战性，许多患者无法通过一线疗法治疗 CRSwNP 和哮喘。目前有六种生物制剂获准用于治疗哮喘和/或严重的 CRSwNP：奥马珠单抗（omalizumab）、mepolizumab、reslizumab、benralizumab、dupilumab 和 tezepelumab。随着呼吸系统生物制剂治疗哮喘和 CRSwNP 的问世，临床医生现在有了更多治疗非甾体抗炎药物引起的哮喘和 CRSwNP 患者的选择。在此，我们将回顾目前可用的临床试验和真实世界证据，说明生物制剂对非甾体类抗炎药物引起的ERD患者的疗效和安全性，讨论生物制剂治疗非甾体类抗炎药物引起的ERD的机制，并回顾有关使用生物制剂治疗与内窥镜鼻窦手术治疗CRSwNP和非甾体类抗炎药物引起的ERD的证据。我们将为非甾体抗炎药物引起的胃食管反流患者提出一种管理方法，即选择生物疗法或内窥镜鼻窦手术，并在脱敏后使用阿司匹林治疗。

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Efficacy of Biologics in NSAID-ERD: United Airways From the Nose to the Bronchi

Nonsteroidal anti-inflammatory drug (NSAID)–exacerbated respiratory disease (NSAID-ERD), the clinical triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and respiratory reactions to cyclooxygenase 1 inhibitors, is often challenging to manage, with many patients failing first-line therapies for CRSwNP and asthma. There are now 6 biologic medications approved for asthma and/or severe CRSwNP: omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab. With the availability of respiratory biologic treatment for both asthma and CRSwNP, clinicians now have a multitude of additional management options for patients with NSAID-ERD. Herein, we review the currently available clinical trial and real-world evidence for biologic efficacy and safety in patients with NSAID-ERD, discuss the mechanisms of biologic therapy specific to NSAID-ERD, and review evidence regarding the use of biologic therapy versus endoscopic sinus surgery for CRSwNP in patients with NSAID-ERD. We propose a management approach for choosing biologic therapy or endoscopic sinus surgery paired with aspirin therapy after desensitization for patients with NSAID-ERD.

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.