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NEJM:Dupilumab对皮质激素依赖性重度哮喘患者的疗效显著

2018-05-22 zhangfan MedSci原创

研究认为,对于皮质激素依赖性重度哮喘患者,Dupilumab治疗可以减少激素用量,降低恶化率同时增加1s呼气量

Dupilumab是一种全人抗白细胞介素4受体α单克隆抗体,可以同时抑制白介素4和13信号通路。近日研究人员考察了Dupilumab对激素依赖性重度哮喘患者的疗效。

研究招募了210名接受皮质激素治疗的哮喘患者,在激素治疗的基础上添加300mg的Dupilumab或安慰剂治疗,每2周一次,持续24周。在治疗开始后4周,逐步减少激素的用量直至20周,最后采取稳定的激素疗法,持续4周。研究的主要终点是24周后激素用量减少百分比,次要终点包括激素剂量减少50%的患者比例、激素日用量小于5mg患者比例、严重恶化率以及一秒用力呼气量(FEV1)。

Dupilumab组患者激素使用减少70.1%,而安慰剂组减少41.9%。Dupilumab组vs安慰剂组,激素用量减少50%患者比例分别为80%和50%;激素日用量小于5mg患者比例分别为69%和33%;激素停药比例分别为48%和25%。Dupilumab组患者哮喘恶化率为59%,低于对照组,FEV1增加0.22L。治疗相关的不良事件主要是注射部位反应以及暂时性嗜酸性粒细胞增加。

研究认为,对于皮质激素依赖性重度哮喘患者,Dupilumab治疗可以减少激素用量,降低恶化率同时增加1s呼气量。

原始出处:

Klaus F. Rabe et al. Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. N Engl J Med. May 21, 2018.

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    2018-12-24 snf701207
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    2018-05-24 13718711b3m

    学习了.获益匪浅.感谢分享

    0

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    2018-05-24 zhyy88
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    2018-05-22 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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