阿奇霉素联合单克隆抗体治疗重症嗜酸性粒细胞哮喘的疗效

IF 9 1区医学 Q1 RESPIRATORY SYSTEM

Thorax Pub Date : 2024-12-18 DOI:10.1136/thorax-2024-221977

Gabriel Lavoie, Imran Howell, James Melhorn, Catherine Borg, Laura Bermejo-Sanchez, Jack Seymour, Maisha F. Jabeen, Anastasia Fries, Gareth Hynes, Ian D Pavord, Nayia Petousi, Timothy SC Hinks

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引用次数: 0

摘要

在严重哮喘的吸入治疗中加入大环内酯类药物可减少病情恶化。然而，目前几乎没有公开发表的证据表明大环内酯类药物对接受生物制剂治疗的患者有效。我们对本中心所有在使用生物制剂时开始使用阿奇霉素的患者进行了回顾性审核。与未开始使用阿奇霉素的患者相比，这些患者的病情加重更多，表现为慢性支气管炎和/或频繁的化脓性病情加重。在生物制剂中添加阿奇霉素可降低类固醇治疗和抗生素治疗的年度加重率，改善症状评分（哮喘控制问卷-5），但与肺功能的改善无关。数据支持在临床试验中对使用生物制剂且病情仍有恶化的患者进行阿奇霉素测试。

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Effects of azithromycin in severe eosinophilic asthma with concomitant monoclonal antibody treatment

Macrolides reduce exacerbations when added to inhaled therapy in severe asthma. However, there is little published evidence for effectiveness in patients treated with biologics. We conducted a retrospective audit of all patients who started azithromycin while on biologics in our centre. Compared with those that did not start azithromycin, these individuals had more exacerbations and a phenotype of chronic bronchitis and/or frequent purulent exacerbations. The addition of azithromycin to biologics was associated with reduced annual rates of steroid-treated and antibiotic-treated exacerbations and improved symptom scores (Asthma Control Questionnaire-5) but not with any improvement in lung function. Data support testing azithromycin in clinical trials in patients on biologics with residual exacerbations.

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来源期刊

Thorax 医学-呼吸系统

CiteScore

16.10

自引率

2.00%

发文量

197

审稿时长

1 months

期刊介绍： Thorax stands as one of the premier respiratory medicine journals globally, featuring clinical and experimental research articles spanning respiratory medicine, pediatrics, immunology, pharmacology, pathology, and surgery. The journal's mission is to publish noteworthy advancements in scientific understanding that are poised to influence clinical practice significantly. This encompasses articles delving into basic and translational mechanisms applicable to clinical material, covering areas such as cell and molecular biology, genetics, epidemiology, and immunology.