奥马珠单抗可改善阿司匹林所致的呼吸系统疾病急性加重患者的呼吸道外症状
2023/07/21
摘要
背景：奥马珠单抗是一种抗IgE抗体，对治疗阿司匹林所致的呼吸系统疾病急性加重（AERD）的呼吸道症状具有临床疗效。然而，一些AERD患者也出现呼吸外（胸部，胃肠道和/或皮肤）症状，这些症状通过常规治疗无法缓解，但可以通过全身皮质类固醇治疗而有所缓解。
目的：我们评估了奥马珠单抗对与AERD相关的呼吸外症状的疗效。
方法：在研究1中，回顾性研究了2009年7月至2019年3月期间在相模原国立医院连续27例AERD患者最初使用奥马珠单抗的情况。在奥马珠单抗治疗之前和之后比较AERD相关的呼吸外症状加重的频率。在研究2中，我们报告了在我们之前的随机试验（登记号UMIN000018777）中研究的3例AERD患者中阿司匹林刺激诱导的呼吸外症状，该试验评估了奥马珠单抗对对AERD患者阿司匹林刺激期间超敏反应的影响。在安慰剂和奥玛单抗治疗阶段比较阿司匹林刺激期间引起的呼吸外症状。
结果：在研究1中，奥马珠单抗治疗与胸痛加重频率降低相关（加重频率≥1次/年，6[22.2%]vs 0；P<0.001），胃肠道症状（9[33.3%]vs 2[7.4%]；P=0.016）和皮肤症状（16[59.3%]vs 2[7.4%]；P<0.001），即使在治疗相关的全身皮质类固醇剂量减少的情况下也是如此。在研究2中，奥马珠单抗也减轻了阿司匹林刺激诱导的所有呼吸外症状。
结论：奥马珠单抗改善了基线（无阿司匹林暴露）和阿司匹林刺激诱导期间的呼吸外症状。
Omalizumab ameliorates extrarespiratory symptoms in patients with aspirin-exacerbated respiratory disease.
Hayashi H, Fukutomi Y, Mitsui C
Abstrast
Background: Omalizumab, an anti-IgE antibody, has clinical efficacy against respiratory symptoms of aspirin-exacerbated respiratory disease (AERD). However, some patients with AERD also present with extrarespiratory (chest, gastrointestinal, and/or cutaneous) symptoms, which are resistant to conventional treatment but can be alleviated by systemic corticosteroids.
Objective: We evaluated the efficacy of omalizumab on extrarespiratory symptoms related to AERD.
Methods: In study 1, a total of 27 consecutive patients with AERD initially prescribed omalizumab at Sagamihara National Hospital between July 2009 and March 2019 were retrospectively studied. Frequency of exacerbations of AERD-related extrarespiratory symptoms was compared before and after omalizumab treatment. In study 2, we reported 3 AERD cases with aspirin challenge-induced extrarespiratory symptoms among patients studied in our previous randomized trial (registration UMIN000018777), which evaluated the effects of omalizumab on hypersensitivity reactions during aspirin challenge to AERD patients. Extrarespiratory symptoms induced during the aspirin challenge were compared between placebo and omalizumab phases.
Results: In study 1, omalizumab treatment was associated with decrease in frequency of exacerbation of chest pain (no. [%] of patients with exacerbation frequency ≥1 time per year, 6 [22.2%] vs 0; P < .001), gastrointestinal symptoms (9 [33.3%] vs 2 [7.4%]; P = .016), and cutaneous symptoms (16 [59.3%] vs 2 [7.4%]; P < .001), even under conditions of treatment-related reduction in systemic corticosteroid dose. Omalizumab also attenuated all the extrarespiratory symptoms during aspirin challenge in study 2.
Conclusions: Omalizumab ameliorated extrarespiratory symptoms at baseline (without aspirin exposure) and during aspirin challenge.
背景：奥马珠单抗是一种抗IgE抗体，对治疗阿司匹林所致的呼吸系统疾病急性加重（AERD）的呼吸道症状具有临床疗效。然而，一些AERD患者也出现呼吸外（胸部，胃肠道和/或皮肤）症状，这些症状通过常规治疗无法缓解，但可以通过全身皮质类固醇治疗而有所缓解。
目的：我们评估了奥马珠单抗对与AERD相关的呼吸外症状的疗效。
方法：在研究1中，回顾性研究了2009年7月至2019年3月期间在相模原国立医院连续27例AERD患者最初使用奥马珠单抗的情况。在奥马珠单抗治疗之前和之后比较AERD相关的呼吸外症状加重的频率。在研究2中，我们报告了在我们之前的随机试验（登记号UMIN000018777）中研究的3例AERD患者中阿司匹林刺激诱导的呼吸外症状，该试验评估了奥马珠单抗对对AERD患者阿司匹林刺激期间超敏反应的影响。在安慰剂和奥玛单抗治疗阶段比较阿司匹林刺激期间引起的呼吸外症状。
结果：在研究1中，奥马珠单抗治疗与胸痛加重频率降低相关（加重频率≥1次/年，6[22.2%]vs 0；P<0.001），胃肠道症状（9[33.3%]vs 2[7.4%]；P=0.016）和皮肤症状（16[59.3%]vs 2[7.4%]；P<0.001），即使在治疗相关的全身皮质类固醇剂量减少的情况下也是如此。在研究2中，奥马珠单抗也减轻了阿司匹林刺激诱导的所有呼吸外症状。
结论：奥马珠单抗改善了基线（无阿司匹林暴露）和阿司匹林刺激诱导期间的呼吸外症状。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(J Allergy Clin Immunol 2023 Jun;151(6); doi: 10.1016/j.jaci.2023.03.014.IF: 10.228)
(J Allergy Clin Immunol 2023 Jun;151(6); doi: 10.1016/j.jaci.2023.03.014.IF: 10.228)
Omalizumab ameliorates extrarespiratory symptoms in patients with aspirin-exacerbated respiratory disease.
Hayashi H, Fukutomi Y, Mitsui C
Abstrast
Background: Omalizumab, an anti-IgE antibody, has clinical efficacy against respiratory symptoms of aspirin-exacerbated respiratory disease (AERD). However, some patients with AERD also present with extrarespiratory (chest, gastrointestinal, and/or cutaneous) symptoms, which are resistant to conventional treatment but can be alleviated by systemic corticosteroids.
Objective: We evaluated the efficacy of omalizumab on extrarespiratory symptoms related to AERD.
Methods: In study 1, a total of 27 consecutive patients with AERD initially prescribed omalizumab at Sagamihara National Hospital between July 2009 and March 2019 were retrospectively studied. Frequency of exacerbations of AERD-related extrarespiratory symptoms was compared before and after omalizumab treatment. In study 2, we reported 3 AERD cases with aspirin challenge-induced extrarespiratory symptoms among patients studied in our previous randomized trial (registration UMIN000018777), which evaluated the effects of omalizumab on hypersensitivity reactions during aspirin challenge to AERD patients. Extrarespiratory symptoms induced during the aspirin challenge were compared between placebo and omalizumab phases.
Results: In study 1, omalizumab treatment was associated with decrease in frequency of exacerbation of chest pain (no. [%] of patients with exacerbation frequency ≥1 time per year, 6 [22.2%] vs 0; P < .001), gastrointestinal symptoms (9 [33.3%] vs 2 [7.4%]; P = .016), and cutaneous symptoms (16 [59.3%] vs 2 [7.4%]; P < .001), even under conditions of treatment-related reduction in systemic corticosteroid dose. Omalizumab also attenuated all the extrarespiratory symptoms during aspirin challenge in study 2.
Conclusions: Omalizumab ameliorated extrarespiratory symptoms at baseline (without aspirin exposure) and during aspirin challenge.
上一篇：
非甾体类抗炎药（NSAID）诱导呼吸道疾病患者的生物治疗后NSAID耐受性研究：一项随机比较试验
下一篇：
Dupilumab在中至重度哮喘儿童中的药代动力学及其对2型生物标志物的影响
