Abstract：
BACKGROUND: Dupilumab has clinical effects in patients with moderate-to-severe asthma. When considering interleukin (IL)-4 and IL-13 signaling, effects of dupilumab on airway mucus hypersecretion and airway remodeling are expected, but they have been reported in only a few short-term studies. Its efficacy for airway hyperresponsiveness (AHR) remains unknown. We comprehensively assessed the efficacy of dupilumab, especially for subjective and objective measures of airway mucus hypersecretion and airway dimensions in moderate-to-severe asthmatic patients.
METHODS: In 28 adult patients with moderate-to-severe uncontrolled asthma, the comprehensive efficacy of 48-week dupilumab treatment, including the Cough and Sputum Assessment Questionnaire (CASA-Q), radiological mucus scores and airway dimensions on computed tomography (CT), was assessed prospectively. Treatment responsiveness to dupilumab was analyzed.
RESULTS: With 48-week dupilumab treatment, all four cough and sputum domain scores of CASA-Q improved significantly. Radiological mucus scores and airway wall thickening on CT were significantly decreased. The decreases in mucus scores were significantly associated with improvements in Asthma Control Questionnaire scores, Asthma Quality of Life Questionnaire (AQLQ) overall scores, airway obstruction, and airway type 2 inflammation. When defined by > 0.5 improvement in AQLQ overall scores, 18 patients (64%) were identified as responders.
CONCLUSIONS: Dupilumab reversed subjective and objective measures of airway mucus hypersecretion and some aspects of airway remodeling in patients with moderate-to-severe uncontrolled asthma.
METHODS: In 28 adult patients with moderate-to-severe uncontrolled asthma, the comprehensive efficacy of 48-week dupilumab treatment, including the Cough and Sputum Assessment Questionnaire (CASA-Q), radiological mucus scores and airway dimensions on computed tomography (CT), was assessed prospectively. Treatment responsiveness to dupilumab was analyzed.
RESULTS: With 48-week dupilumab treatment, all four cough and sputum domain scores of CASA-Q improved significantly. Radiological mucus scores and airway wall thickening on CT were significantly decreased. The decreases in mucus scores were significantly associated with improvements in Asthma Control Questionnaire scores, Asthma Quality of Life Questionnaire (AQLQ) overall scores, airway obstruction, and airway type 2 inflammation. When defined by > 0.5 improvement in AQLQ overall scores, 18 patients (64%) were identified as responders.
CONCLUSIONS: Dupilumab reversed subjective and objective measures of airway mucus hypersecretion and some aspects of airway remodeling in patients with moderate-to-severe uncontrolled asthma.
摘要：
背景：Dupilumab对中度至重度哮喘患者有临床疗效。当考虑白细胞介素（IL）-4和IL-13信号时，预计dupilumab对气道粘液高分泌和气道重塑的影响，但是只有少数短期研究报告了它们。其对气道高反应性（AHR）的疗效尚不清楚。我们全面评估了dupilumab的疗效，尤其是对中重度哮喘患者气道粘液高分泌和气道尺寸的主观和客观测量。
方法：在28名中度至重度未控制哮喘的成年患者中，48周dupilumab治疗的综合疗效，包括咳嗽和痰评估问卷（CASA-Q），计算机断层扫描（CT）上的放射学粘液评分和气道尺寸，进行了前瞻性评估。分析了对dupilumab的治疗反应性。
结果：使用48周的dupilumab治疗，CASA-Q的所有四个咳嗽和痰领域评分均显着改善。CT上的放射粘液评分和气道壁增厚显着降低。粘液评分的降低与哮喘控制问卷评分的改善显着相关，哮喘生活质量问卷（AQLQ）总分，气道阻塞,和气道2型炎症。当定义为AQLQ总分提高>0.5时，18名患者(64%)被确定为应答者。
结论：Dupilumab逆转了中度至重度未控制哮喘患者气道粘液高分泌的主观和客观指标以及气道重塑的某些方面。
方法：在28名中度至重度未控制哮喘的成年患者中，48周dupilumab治疗的综合疗效，包括咳嗽和痰评估问卷（CASA-Q），计算机断层扫描（CT）上的放射学粘液评分和气道尺寸，进行了前瞻性评估。分析了对dupilumab的治疗反应性。
结果：使用48周的dupilumab治疗，CASA-Q的所有四个咳嗽和痰领域评分均显着改善。CT上的放射粘液评分和气道壁增厚显着降低。粘液评分的降低与哮喘控制问卷评分的改善显着相关，哮喘生活质量问卷（AQLQ）总分，气道阻塞,和气道2型炎症。当定义为AQLQ总分提高>0.5时，18名患者(64%)被确定为应答者。
结论：Dupilumab逆转了中度至重度未控制哮喘患者气道粘液高分泌的主观和客观指标以及气道重塑的某些方面。
