Allergol Int:屋尘螨舌下免疫治疗片作为dupilumab的补充治疗时,对哮喘伴鼻炎的疗效

2022-06-27 AlexYang MedSci原创

评估了真实世界环境中,对未被Dupilumab最佳控制的哮喘伴鼻炎患者,使用HDM SLIT后的结果情况。

过敏原特异性免疫疗法(AIT)是唯一可用的疾病调节治疗方法,在不同层面影响过敏原本身的特异性免疫反应,从而使IgE介导的过敏性疾病患者的症状得以缓解。屋尘螨(HDMs)在全球范围内普遍存在,是过敏性哮喘的一个主要原因。HDM SLIT是控制过敏性哮喘疾病的治疗方法之一,并已在临床试验中显示出疗效。Dupilumab可阻断2型炎症的关键驱动因素,IL-4和IL-13信号。目前已经批准用于不受控制的中度至重度哮喘患者。

近期,来自日本的研究人员在《Allergol Int》上发表文章,评估了真实世界环境中,对未被Dupilumab最佳控制的哮喘伴鼻炎患者,使用HDM SLIT后的结果情况

研究人员在基线和治疗后48周,评估了哮喘控制问卷(ACQ)-5、哮喘生活质量问卷(AQLQ)和鼻结膜炎生活质量问卷(RQLQ)。收集了肺活量、2型炎症生物标志物和气道重塑的定量计算机断层成像参数。

研究共有47名患者接受了HDM SLIT,其中41人完成了研究。HDM SLIT和Dupilumab的联合治疗改善了ACQ-5(p<0.05)、AQLQ(p<0.05)和RQLQ(p < 0.05),并增强了肺功能,减少了FeNO(p < 0.05)和气道百分比壁面积,以及壁厚度(均为p<0.05)。ACQ-5和AQLQ评分的变化与FeNO和FEV1预测百分比的变化均存在关联。多重回归分析显示,FEV1预测百分比的变化是AQLQ改善的独立因素(r2=0.510,p=0.012)。根据预测SLIT反应者的ROC分析,血清HDM特异性IgE、总IgE和FEV1预测百分比的曲线下面积很高(>0.8)。

多变量回归分析鉴定AQLQ变化的独立预测因子

综上所述,在不受控制的哮喘伴鼻炎患者中,他们的结果支持将HDM SLIT加入到药物治疗加Dupilumab中

原始出处:

Makoto Hoshino , Kenta Akitsu , Kengo Kubota et al. Efficacy of a house dust mite sublingual immunotherapy tablet as add-on dupilumab in asthma with rhinitis. Allergol Int. Jun 2022

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    2022-12-19 snf701207
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    2022-06-28 zhyy88
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    2022-06-28 膀胱癌
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    2022-06-27 Ivan_twb

    学习了,谢谢

    0

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    2022-06-27 医鸣惊人

    认真学习了

    0

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