支气管热成形术与美泊利单抗：在严重哮喘门诊的结局比较
2020/12/17
摘要
背景与目的：BT和阻断白介素的单克隆抗体都是重度哮喘的有效疗法，但是这两种疗法之间没有直接比较。这项研究的目的是在真实世界中比较BT和美泊利单抗的疗效和安全性。
方法：入组尽管优化了吸入疗法，但仍患有严重哮喘的来自三级医院重症哮喘门诊的患者。每位开始使用BT或美泊利单抗治疗的患者均被纳入了国家登记。在12个月内的预定评估时间点，评估ACQ，肺活量测定，哮喘加重时的口服皮质类固醇，缓解药物和口服皮质类固醇维持治疗的使用。
结果：共有91例严重哮喘患者参加：平均ACQ评分3.5±1.0，FEV1 51.4±17.7％，维持口服类固醇激素48.3％和每日吸入缓解治疗11.5±10.0。 47例患者接受了美泊利单抗，44例接受了BT。基线特征相似，但美泊利单抗组的血液嗜酸性粒细胞计数明显升高。在12个月时，ACQ的治疗结果（1.9±1.3美泊珠单抗vs 1.7±1.3 BT），恶化率（0.9±1.1 vs 0.9±1.5），缓解剂使用减少（-6.3±10.5 vs -5.0±8.8吸/天）之间没有差异。）或口服皮质类固醇减少（-3.3±7.5 vs-5.8±6.7 mg /天）。 FEV1同样提高（160±290 vs 150±460 mL）。在18.2％的BT患者中观察到再次入院或长期入院，而25.5％的美泊利单抗患者在12个月时停止治疗，其中14.9％是由于不良事件或不依从。
结论：结果表明，BT在治疗严重哮喘方面与美泊利单抗一样有效。
Bronchial thermoplasty versus mepolizumab: Comparison of outcomes in a severe asthma clinic
Langton D, Sha J, Guo S, et al.
Abstract
Background and objective:BT and interleukin-blocking monoclonal antibodies are both effective therapies for severe asthma, but there have been no direct comparisons between the two treatments. The aim of this study was to compare the efficacy and safety of BT and mepolizumab, in a real-world setting.
Methods: Patients with severe asthma despite optimized inhaler therapy were drawn from a severe asthma clinic in a tertiary hospital. Every patient commencing therapy with BT or mepolizumab was prospectively included in a national registry. At predetermined assessment points over a 12-month period, assessments were made of ACQ, spirometry, oral corticosteroid requiring exacerbations, reliever medication and maintenance oral corticosteroid use.
Results: A total of 91 patients with severe asthma participated: mean ACQ score 3.5 ± 1.0, FEV1 51.4 ±17.7%, maintenance oral steroids 48.3% and 11.5 ±10.0 inhalations/day reliever therapy. Forty-seven patients received mepolizumab and 44 received BT. Baseline characteristics were similar except significantly higher blood eosinophil count in the mepolizumab group. At 12 months, there were no differences between treatment outcomes for ACQ (1.9± 1.3 mepolizumab vs 1.7 ±1.3 BT), exacerbation rate (0.9 ±1.1 vs 0.9 ±1.5), reduction in reliever use (−6.3± 10.5 vs −5.0 ± 8.8 puffs/day) or reduction in oral corticosteroids (−3.3± 7.5 vs − 5.8± 6.7 mg/day). The FEV1 improved equally (160 ±290 vs 150± 460 mL). Readmission or prolonged admission was observed in 18.2% of BT patients, whilst 25.5% of mepolizumab patients had discontinued treatment at 12 months, 14.9% due to an adverse event or non-compliance.
Conclusion: The results suggest that BT is as efficacious as mepolizumab for the treatment of severe asthma.
背景与目的：BT和阻断白介素的单克隆抗体都是重度哮喘的有效疗法，但是这两种疗法之间没有直接比较。这项研究的目的是在真实世界中比较BT和美泊利单抗的疗效和安全性。
方法：入组尽管优化了吸入疗法，但仍患有严重哮喘的来自三级医院重症哮喘门诊的患者。每位开始使用BT或美泊利单抗治疗的患者均被纳入了国家登记。在12个月内的预定评估时间点，评估ACQ，肺活量测定，哮喘加重时的口服皮质类固醇，缓解药物和口服皮质类固醇维持治疗的使用。
结果：共有91例严重哮喘患者参加：平均ACQ评分3.5±1.0，FEV1 51.4±17.7％，维持口服类固醇激素48.3％和每日吸入缓解治疗11.5±10.0。 47例患者接受了美泊利单抗，44例接受了BT。基线特征相似，但美泊利单抗组的血液嗜酸性粒细胞计数明显升高。在12个月时，ACQ的治疗结果（1.9±1.3美泊珠单抗vs 1.7±1.3 BT），恶化率（0.9±1.1 vs 0.9±1.5），缓解剂使用减少（-6.3±10.5 vs -5.0±8.8吸/天）之间没有差异。）或口服皮质类固醇减少（-3.3±7.5 vs-5.8±6.7 mg /天）。 FEV1同样提高（160±290 vs 150±460 mL）。在18.2％的BT患者中观察到再次入院或长期入院，而25.5％的美泊利单抗患者在12个月时停止治疗，其中14.9％是由于不良事件或不依从。
结论：结果表明，BT在治疗严重哮喘方面与美泊利单抗一样有效。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Respirology, 2020, 25(12): 1243-1249.）
（Respirology, 2020, 25(12): 1243-1249.）
Bronchial thermoplasty versus mepolizumab: Comparison of outcomes in a severe asthma clinic
Langton D, Sha J, Guo S, et al.
Abstract
Background and objective:BT and interleukin-blocking monoclonal antibodies are both effective therapies for severe asthma, but there have been no direct comparisons between the two treatments. The aim of this study was to compare the efficacy and safety of BT and mepolizumab, in a real-world setting.
Methods: Patients with severe asthma despite optimized inhaler therapy were drawn from a severe asthma clinic in a tertiary hospital. Every patient commencing therapy with BT or mepolizumab was prospectively included in a national registry. At predetermined assessment points over a 12-month period, assessments were made of ACQ, spirometry, oral corticosteroid requiring exacerbations, reliever medication and maintenance oral corticosteroid use.
Results: A total of 91 patients with severe asthma participated: mean ACQ score 3.5 ± 1.0, FEV1 51.4 ±17.7%, maintenance oral steroids 48.3% and 11.5 ±10.0 inhalations/day reliever therapy. Forty-seven patients received mepolizumab and 44 received BT. Baseline characteristics were similar except significantly higher blood eosinophil count in the mepolizumab group. At 12 months, there were no differences between treatment outcomes for ACQ (1.9± 1.3 mepolizumab vs 1.7 ±1.3 BT), exacerbation rate (0.9 ±1.1 vs 0.9 ±1.5), reduction in reliever use (−6.3± 10.5 vs −5.0 ± 8.8 puffs/day) or reduction in oral corticosteroids (−3.3± 7.5 vs − 5.8± 6.7 mg/day). The FEV1 improved equally (160 ±290 vs 150± 460 mL). Readmission or prolonged admission was observed in 18.2% of BT patients, whilst 25.5% of mepolizumab patients had discontinued treatment at 12 months, 14.9% due to an adverse event or non-compliance.
Conclusion: The results suggest that BT is as efficacious as mepolizumab for the treatment of severe asthma.
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人骨髓间充质干细胞治疗急性哮喘小鼠模型气道炎症的频率评价
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支气管热成形术减少了由多次呼吸氮冲洗技术测量的通气异质性
