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NEJM:Tezepelumab可有效治疗未控制哮喘

2017-09-08 MedSci MedSci原创

在某些中重度哮喘患者中,特别是那些伴有非嗜酸性粒细胞炎症的患者,其病情仍然不受控制。本实验旨在尽管接受长效β受体激动剂和中高剂量吸入糖皮质激素治疗仍未能控制其哮喘的人群中评价tezepelumab(AMG 157/MEDI9929)——靶向上皮细胞衍生因子胸腺基质淋巴细胞(TSLP)的单克隆抗体的疗效和安全。在这项2期、随机、双盲、安慰剂对照试验中,研究人员比较了三个剂量水平的tezepeluma

在某些中重度哮喘患者中,特别是那些伴有非嗜酸性粒细胞炎症的患者,其病情仍然不受控制。本实验旨在尽管接受长效β受体激动剂和中高剂量吸入糖皮质激素治疗仍未能控制其哮喘的人群中评价tezepelumab(AMG 157/MEDI9929)——靶向上皮细胞衍生因子胸腺基质淋巴细胞(TSLP)的单克隆抗体的疗效和安全。

在这项2期、随机、双盲、安慰剂对照试验中,研究人员比较了三个剂量水平的tezepelumab皮下注射与安慰剂的效果,治疗时间为52周。主要终点是第52周时患者哮喘恶化的年化率。

结果,每4周应用tezepelumab 70 mg(低剂量;145例)、210 mg(中等剂量;145例)及每2周应用280 mg(高剂量;146例)导致52周时患者哮喘发作率分别为0.26、0.19和0.22,而安慰剂组(148例)为0.67。因此,tezepelumab治疗各组哮喘发作率分别较安慰剂组降低了61%、71%和66%(P<0.001)。Tezepelumab治疗组患者支气管扩张前的1秒钟用力呼气容积在52周时较安慰剂组高(差异,低剂量0.12升[ P = 0.01 ],中剂量0.11升[ P = 0.02 ],高剂量0.15升[ P = 0.002 ])。中剂量组2例,高剂量组3例,安慰剂组1例,因不良事件终止试验方案。

总之,该研究发现表明,在长效β受体激动剂和中高剂量吸入糖皮质激素治疗的患者中,接受tezepeluma可降低哮喘的发作率,且其效果独立于基线时期血嗜酸性粒细胞计数。


原始出处:

Jonathan Corren,Jane R. Parnes, et al.,Tezepelumab in Adults with Uncontrolled Asthma. N Engl J Med 2017; 377:936-946September 7, 2017DOI: 10.1056/NEJMoa1704064.

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    2018-03-01 snf701207
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    2018-07-27 feather89
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    2017-09-10 tidiq
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    2017-09-09 明天会更好!

    不错的文章.值得一读

    0

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    2017-09-08 131****1460

    学习了受益匪浅.

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    2017-09-08 戒馋,懒,贪

    谢谢分享.超厉害的说

    0

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