定义严重哮喘的生物制剂治疗反应:从全球评估到超级反应和缓解。

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM
Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-06-19 DOI:10.1080/17476348.2023.2226392
Andriana I Papaioannou, Evangelia Fouka, Konstantinos Bartziokas, Maria Kallieri, Angelos Vontetsianos, Konstantinos Porpodis, Nikoletta Rovina, Stelios Loukides, Petros Bakakos
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引用次数: 0

摘要

引言:近年来,针对2型炎症途径的单克隆抗体已被开发用于严重哮喘的治疗。然而,即使仔细选择了患者,对治疗的反应也各不相同。涵盖领域:不同的研究评估了生物制剂治疗的反应,如病情恶化减轻、症状改善、肺功能增加、生活质量改善或口服皮质类固醇减少,表明所有患者对所有疾病方面都没有反应,并导致了关于反应定义的广泛争论。专家意见:评估对治疗的反应非常重要,但由于对治疗反应没有统一的定义,承认真正从这些治疗中受益的患者仍然是一个未满足的需求。在同样的背景下,确定无反应的患者,在这些患者中,生物治疗应该被替代治疗方案所取代,这一点至关重要。在这篇综述中,我们通过介绍当前的相关医学文献,介绍了严重哮喘患者对生物制剂治疗反应的定义。我们还提出了反应的预测因素,重点是所谓的超级反应者。最后,我们讨论了最近关于哮喘缓解作为可行治疗目标的见解,并为评估反应提供了一个简单的算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Defining response to therapy with biologics in severe asthma: from global evaluation to super response and remission.

Introduction: In recent years, monoclonal antibodies targeting Type-2 inflammatory pathways have been developed for severe asthma treatment. However, even when patients are carefully selected, the response to treatment varies.

Areas covered: Different studies have evaluated response to therapy with biologics such as exacerbation reduction, symptom improvement, pulmonary function increase, improvement in QoL, or decrease of oral corticosteroids, showing that all patients do not respond to all disease aspects and leading to an extensive debate regarding the definition of response.

Expert opinion: Assessing response to therapy is of great importance, but since there is no uniform definition of treatment response, the recognition of patients who really benefit from these therapies remains an unmet need. In the same context, identifying non-responding patients in which biologic therapy should be switched or substituted by alternative treatment options is of paramount importance. In this review, we present the road trip of the definition of therapeutic response to biologics in severe asthmatics by presenting the current relevant medical literature. We also present the suggested predictors of response, with an emphasis on the so-called super-responders. Finally, we discuss the recent insights regarding asthma remission as a feasible treatment goal and provide a simple algorithm for the evaluation of response.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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