重度哮喘患者通常依赖口服皮质类固醇(OCS)并经常加重。本文旨在报道重度嗜酸性粒细胞性哮喘患者评估哮喘控制的长期数据,肺功能,吸入性皮质类固醇(ICS)剂量减少,以及接受美泊利单抗治疗的患者的临床和生物学参数。
■4例重度嗜酸性粒细胞性哮喘成人患者接受美泊利单抗100mg/4周治疗60个月或更长时间,导致OCS的稳定停止,被呈现。ICS剂量,OCS剂量和停药日期,肺功能,嗜酸性粒细胞计数,呼出气一氧化氮,我们记录了开始美泊利单抗治疗前12个月和最后一次随访访视前12个月的哮喘控制测试以及恶化情况.
■三个病人是男性,中位年龄为52.5岁(范围79-53),美泊利单抗开始前哮喘中位病程为67.5个月(范围24-240个月),其中3人患有慢性鼻-鼻窦炎,无鼻息肉,2人患有特应性。在基线时,所有的嗜酸性粒细胞计数均>300个细胞/μL。中位随访时间为73.5个月(范围71-74),和OCS从基线退出发生在中位治疗13个月后(范围12-39).记录了ICS治疗的大幅减少以及哮喘控制测试的改善,呼出气一氧化氮和功能参数,与基线前12个月相比,上次访视前12个月的加重显著减少(从中位数4(范围3-6)降至0;p=0.0286).
■Mepolizumab可能是一种“改善疾病”的药物,具有较高的耐受性和长期良好的疗效。
UNASSIGNED: Patients with severe asthma are often dependent on oral corticosteroids (OCS) and have frequent exacerbations. This article aims to report very long-term data of patients with severe eosinophilic asthma assessing asthma control, lung function, inhaled corticosteroid (ICS) dose reduction, and clinical and biological parameters of patients treated with mepolizumab.
UNASSIGNED: Four cases of adult patients with severe eosinophilic asthma who were treated for 60 months or more with mepolizumab 100 mg/4 weeks, leading to the stable discontinuation of OCS, are presented. ICS dose, OCS dose and withdrawal date, lung function, eosinophil count, fractional exhaled nitric oxide, and asthma control test were recorded as well as exacerbations in the 12 months before commencing mepolizumab and in the 12 months before the last follow-up visit.
UNASSIGNED: Three of the patients were men, median age was 52.5 years (range 79-53), median length of asthma before mepolizumab start was 67.5 months (range 24-240), three had chronic rhinosinusitis without nasal polyposis and two were atopic. All had eosinophil counts >300 cells/μL at baseline. The median follow-up was 73.5 months (range 71-74), and OCS withdrawal from baseline occurred after a median of 13 months of mepolizumab treatment (range 12-39). A substantial reduction of ICS treatment was registered as well as improvement in asthma control test, fractional exhaled nitric oxide and functional parameters, and a significant reduction of exacerbations in the last 12 months before last visit was observed as compared to the 12 months before baseline (from a median of 4 (range 3-6) to 0; p=0.0286).
UNASSIGNED: Mepolizumab could be a \'disease-modifying\' agent, with high tolerability and a good efficacy profile in the long term.