哮喘联盟

   摘要
   背景：众所周知很严重的哮喘患者尽管经过有效的治疗仍难实现哮喘控制。本研究旨在评估加用奥马珠单抗治疗对于重度哮喘患者哮喘控制的疗效，患者来自葡萄牙里斯本市普利多瓦伦特医院《重度哮喘门诊诊所》。
   方法：一项回顾性研究通过ACT评分和GINA分级、急性发作的严重程度和频率、药物使用和肺功能评估奥马珠单抗治疗的患者哮喘控制情况。通过开始治疗时以及6、12和24个月随访时的病例搜集临床资料。
   结果：26例患者开始使用奥马珠单抗治疗，基于GINA分级治疗前所有患者(100%)均为哮喘未控制。平均ACT评分为11.5。所有患者均使用固定剂量ICS和LABA治疗，其中34.6%也使用抗胆碱吸入器。42.3%的患者为了哮喘控制也使用口服糖皮质激素治疗。患者自述平均每年有1.8次中度以及3.1次重度的急性发作。在6个月时大多数终点均发现有统计学差异：GINA评分改善：60.9%的患者哮喘部分控制，仅39.1%的患者哮喘未控制(Wilcoxon 0.00)；ACT评分提高到19.52(Wilcoxon 0.00)；平均FEV1提高到76.7% (Wilcoxon 0.025)；需要口服糖皮质激素治疗的患者比例减少到17.4%(Wilcoxon 0.014)；同样中度和重度急性发作次数分别减少到1.04 (Wilcoxon 0.007)和 1.83( Wilcoxon 0.002)。
   结论：GINA 第5级治疗中加用奥马珠单抗可有效的改善哮喘控制。
 

（林江涛 审校）
RevPortPneumol.2014Feb10.pii:S0873-2159(13)00128-1.doi:10.1016/j.rppneu.2013.07.006. [Epub ahead of print]

 

Clinical experience with omalizumab in a Portuguese severe asthma unit.
 

 [Article in English, Portuguese]

Alfarroba S1, Videira W2, Galvão-Lucas C1, Carvalho F3, Bárbara C1.
 

Abstract
BACKGROUND: It is widely recognized that asthma control is not always possible in patients with very severe asthma despite available treatment. The aim of this study was to evaluate the efficacy of Omalizumab on asthma control as an add-on therapy in patients from the «Severe Asthma Outpatient Clinic» of Pulido Valente Hospital in Lisbon, Portugal.
METHODS: A retrospective study was conducted to assess asthma control by the ACT score and by GINA classification, frequency and severity of exacerbations, medication use and pulmonary function in patients treated with Omalizumab. Clinical information was collected from medical records from the start of treatment and at 6, 12 and 24 month follow-up.
RESULTS: 26 patients started treatment with Omalizumab, all (100%) were classified by GINA with uncontrolled asthma prior to treatment. Mean ACT score was 11.5. All patients had treatment with fixed-dose ICS and LABA and 34.6% also had an anti-cholinergic inhaler. 42.3% of patients were also treated with oral glucocorticosteroids for control. Patients reported an average of 1.8 moderate and 3.1 severe exacerbations/year. Statistical differences were found at 6 month follow-up in most end-points: GINA score improved: 60.9% of patients with partially controlled asthma and only 39.1% with uncontrolled asthma (Wilcoxon 0.00); ACT score improved to 19.52 (Wilcoxon 0.00); mean FEV1 improved to 76.7% (Wilcoxon 0.025); the proportion of patients requiring oral glucocorticosteroid therapy reduced to 17.4% (Wilcoxon 0.014); and the number of moderate and severe exacerbations also decreased to 1.04 and 1.83 respectively (Wilcoxon 0.007; Wilcoxon 0.002 respectively).
CONCLUSIONS: The current analysis shows evidence that omalizumab is successful in improving asthma control as an add-on therapy GINA step 5 treatment.
 

RevPortPneumol.2014Feb10.pii:S0873-2159(13)00128-1.doi:10.1016/j.rppneu.2013.07.006. [Epub ahead of print]