目的:重度嗜酸性粒细胞哮喘(SEA)的特征是高嗜酸性粒细胞增多,严重症状,重要的合并症,频繁加重,哮喘控制不佳。Benralizumab,靶向白细胞介素-5受体α,证明可有效诱导嗜酸性粒细胞快速消耗并改善症状和肺功能;它还可以减少恶化和使用口服皮质类固醇(OCS)。本案系列,跨越不同的SEA亚型,旨在扩大benralizumab在意大利的真实世界体验。
方法:我们收集了用贝那利珠单抗治疗的SEA患者的数据,在基线和治疗期间。我们关注贝那利珠单抗在以下情况和终点中的作用:i)高IgE和高嗜酸性粒细胞哮喘之间的重叠;ii)存在鼻息肉病作为共病;iii)保留皮质类固醇作用;iv)患者感知。
结果:纳入10例SEA患者(女性:N=7;年龄范围:19-70岁)转诊至8个意大利中心并接受贝那利珠单抗治疗,出现几种合并症,如非过敏性疾病(8/10),atopy(3/10),高IgE(5/10)和鼻息肉病(6/10)。总的来说,贝那利珠单抗在所有患者中产生最佳的疾病控制,特别是在快速临床和功能改善方面,减少全身性类固醇需求(OCS治疗完全停止7例)和改善患者生活质量,除了1例,其中与贝那利珠单抗治疗无关的其他病症干扰了患者的感知。
结论:我们的发现进一步支持贝那利珠单抗在随机临床试验中的疗效和安全性,为改善肺功能提供更好的结果。
OBJECTIVE: Severe eosinophilic asthma (SEA) is characterized by high eosinophilia, severe symptoms, important comorbidities, frequent exacerbations, and poor asthma control. Benralizumab, targeting the interleukin-5 receptor alpha, proved effective in inducing rapid eosinophil depletion and amelioration of symptoms and lung function; it also allowed to reduce exacerbations and the use of oral corticosteroids (OCS). The present
case series, spanning different subtypes of SEA, aimed at expanding the real-world experience with benralizumab in Italy.
METHODS: We collected data from SEA patients treated with benralizumab, at baseline and during treatment. We focused on the effects of benralizumab in the following conditions and endpoints: i) overlap between high-IgE and high-eosinophilic asthma; ii) presence of nasal
polyposis as comorbidity; iii) corticosteroid-sparing effect; iv) patient perception.
RESULTS: Ten SEA patients (females: N=7; age range: 19-70 years) referred to 8 Italian Centers and treated with benralizumab were included, presenting with several comorbidities such as non-allergic disease (8/10), atopy (3/10), high IgE (5/10) and nasal
polyposis (6/10). Overall, benralizumab yielded optimal disease control in all patients, particularly in terms of rapid clinical and functional improvement, decreased systemic steroid need (OCS therapy was completely discontinued in 7 cases) and amelioration of patient quality of life, except for 1
case, in whom other conditions not related to benralizumab therapy interfered with the patient perception.
CONCLUSIONS: Our findings further support the efficacy and safety of benralizumab observed in randomized clinical trials, providing even better results for lung function improvement.