奥马珠单抗治疗慢性鼻窦炎伴鼻腔息肉及哮喘：一项真实世界研究
2018/01/15
慢性鼻窦炎伴鼻腔息肉(CRSwNP)及哮喘常常合并存在，因此两者兼治的策略具有前景。
目的：前瞻性评估抗IgE单克隆抗体奥马珠单抗治疗重症过敏性哮喘同时可以有效治疗合并的CRSwNP。
方法：一项队列研究纳入CRSwNP合并重症难治性过敏性哮喘患者，根据英国重症哮喘治疗指南，全部接受奥马珠单抗治疗（n=13）,在治疗第4周和16周分别记录SNOT-22和ACQ-7评分。对照组为仅接受手术治疗的患者（n=24），并记录SNOT-22评分。
结果：在治疗第4周和16周，接受奥马珠单抗治疗患者临床症状快速改善。接受奥马珠单抗治疗组与接受手术治疗组患者疗效改善相当。
结论：重症哮喘患者接受奥马珠单抗治疗可以改善合并CRSwNP。进一步针对重症哮喘的现有和即将应用的药物研究应纳入上气道转归结果。这些药物对于重症CRSwNP疗效应与手术治疗进行比较。
Rhinology. 2017 Dec 30. doi: 10.4193/Rhin17.139. [Epub ahead of print]
Bidder T, Sahota J, Rennie C, Lund VJ, Robinson DS, Kariyawasam HH.
Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy.
OBJECTIVE:To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP.
METHODS:SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared.
RESULTS:Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery.
CONCLUSION:Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.
目的：前瞻性评估抗IgE单克隆抗体奥马珠单抗治疗重症过敏性哮喘同时可以有效治疗合并的CRSwNP。
方法：一项队列研究纳入CRSwNP合并重症难治性过敏性哮喘患者，根据英国重症哮喘治疗指南，全部接受奥马珠单抗治疗（n=13）,在治疗第4周和16周分别记录SNOT-22和ACQ-7评分。对照组为仅接受手术治疗的患者（n=24），并记录SNOT-22评分。
结果：在治疗第4周和16周，接受奥马珠单抗治疗患者临床症状快速改善。接受奥马珠单抗治疗组与接受手术治疗组患者疗效改善相当。
结论：重症哮喘患者接受奥马珠单抗治疗可以改善合并CRSwNP。进一步针对重症哮喘的现有和即将应用的药物研究应纳入上气道转归结果。这些药物对于重症CRSwNP疗效应与手术治疗进行比较。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Rhinology. 2017 Dec 30. doi: 10.4193/Rhin17.139. [Epub ahead of print]）
（Rhinology. 2017 Dec 30. doi: 10.4193/Rhin17.139. [Epub ahead of print]）
Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.
Rhinology. 2017 Dec 30. doi: 10.4193/Rhin17.139. [Epub ahead of print]
Bidder T, Sahota J, Rennie C, Lund VJ, Robinson DS, Kariyawasam HH.
Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy.
OBJECTIVE:To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP.
METHODS:SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared.
RESULTS:Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery.
CONCLUSION:Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.
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免疫治疗在儿童哮喘的系统性综述证据：GRADE系统性综述
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糠酸氟替卡松加维兰特罗控制哮喘有效性的临床实践：一项非盲法、平行组、随机对照试验
