PDF(Pubmed)
Abstract：
Severe eosinophilic asthma is associated with a heavy burden and impact on daily living in patients experiencing uncontrolled symptoms, exacerbations, and treatment side effects. This case study reports a 49-year-old woman who presented to the severe asthma center with uncontrolled severe asthma despite multiple maintenance medications and omalizumab treatment. On presentation, the patient had experienced two to three hospitalizations per year, frequent asthma exacerbations requiring courses of oral corticosteroids, and symptoms that impacted her quality of life. Omalizumab was previously discontinued, and bronchial thermoplasty was also unsuccessful. The patient stabilized on injectable steroids and commenced mepolizumab once available on prescription. Owing to continued exacerbations and an inability to reduce steroid treatment without exacerbating, mepolizumab was discontinued and the patient commenced benralizumab (30 mg subcutaneously every 4 weeks for the first three doses, every 8 weeks thereafter) under the sole care of the severe asthma center. Benralizumab treatment resulted in a reduction in steroid treatment, zero asthma exacerbations, improved asthma control and lung function, and a marked improvement in activity levels that allowed the patient to participate in a long-distance running event. Additionally, 7 months following the initiation of benralizumab treatment, her blood eosinophils were completely depleted. These findings support the use of benralizumab in patients with refractory uncontrolled severe eosinophilic asthma despite previous biologic treatment with omalizumab and mepolizumab, as improvements in clinical and patient outcomes, including quality of life, can be achieved in difficult-to-treat cases.
摘要：
严重的嗜酸性粒细胞性哮喘与经历不受控制症状的患者的沉重负担和对日常生活的影响有关。恶化,和治疗副作用。本案例研究报告了一名49岁的女性，尽管接受了多种维持药物和奥马珠单抗治疗，但仍未控制重症哮喘患者出现在重症哮喘中心。在介绍时，病人每年住院两到三次，频繁的哮喘发作需要口服皮质类固醇的疗程，以及影响她生活质量的症状.奥马珠单抗先前已停用，支气管热成形术也不成功。患者使用可注射类固醇稳定，一旦处方可用，就开始使用美泊利单抗。由于持续恶化和无法减少类固醇治疗而不恶化，停用美泊利单抗，患者开始服用贝那利珠单抗（前三剂每4周皮下30mg，此后每8周）在重症哮喘中心的单独护理下。Benralizumab治疗导致类固醇治疗减少，哮喘发作为零,改善哮喘控制和肺功能，以及活动水平的显着改善，使患者能够参加长跑活动。此外,贝那利珠单抗治疗开始后7个月，她的血嗜酸性粒细胞完全耗尽.这些发现支持在难治性不受控制的重度嗜酸性粒细胞性哮喘患者中使用贝那利珠单抗，尽管先前曾使用奥马珠单抗和美泊利单抗进行生物治疗。随着临床和患者预后的改善，包括生活质量，可以在难以治疗的情况下实现。
