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重大突破!新型疗法让慢性自发性荨麻疹控制不再难!

2021-05-25 rayms MedSci原创

春末夏初,荨麻疹患者又开始陷入无尽的痛苦中,瘙痒难忍,皮肤呈现出鲜红色或苍白色风团,部分患者可伴有恶心、呕吐、头痛、头胀、腹痛,严重者甚至出现胸闷、面色苍白、心率加速、血压下降以及呼吸短促等全身症状。

春末夏初,荨麻疹患者又开始陷入无尽的痛苦中,瘙痒难忍,皮肤呈现出鲜红色或苍白色风团,部分患者可伴有恶心、呕吐、头痛、头胀、腹痛,严重者甚至出现胸闷、面色苍白、心率加速、血压下降以及呼吸短促等全身症状。来自上海交通大学医学院附属瑞金医院皮肤科主任郑捷教授表示,“多数患者荨麻疹发作时瘙痒难忍,这不仅严重影响患者生活质量,而且带来沉重的社会经济和家庭负担。”

瘙痒难忍的荨麻疹,多数疗法并不能完全控制症状

荨麻疹是一种很常见的皮肤病,俗称风团或风疹块,是一种皮肤过敏。荨麻疹分为急性荨麻疹和慢性荨麻疹。从发病时间来看,急性荨麻疹发病时间在6周以内,而慢性荨麻疹则超过6周。慢性荨麻疹分为慢性自发性荨麻疹(CSU)和慢性诱导性荨麻疹,其中CSU患者最为常见,占比为68%,女性约占60%。

CSU的典型表现为无特定外部诱因的情况下出现风团或血管性水肿,伴有瘙痒和/或疼痛感,其病程通常为2-5年,有10%的患者病程在5年以上,甚至部分患者病程超过25年。CSU可由多种原因引起,目前,细菌、病毒、寄生虫或真菌感染被认为是 CSU 的潜在危险因素,其感染的频率因患者人群和地理位置的不同而不同。 

郑捷教授表示,“荨麻疹是一种常见的疾病,在人的一生中90%-95%的人都生过荨麻疹。据数据显示,中国慢性荨麻疹发病率为1.5%,也就是说每100个人当中就有1.5个人患有慢性荨麻疹。遗憾的是,目前慢性荨麻疹潜在的发病机制并不清楚,慢性荨麻疹的治疗仍然以对症治疗为主。另外,慢性荨麻疹常常反复发作,需要采取正确的治疗方法,才可以预防荨麻疹的反复发作。”

目前,国内外指南推荐抗组胺作为慢性荨麻疹的首选药物,同时也是我国唯一获批用于慢性荨麻疹的治疗药物。尽管抗组胺效果明显,但仍有 1/4 - 1/3 的患者不能得到有效控制。

对此,郑捷教授说到,“荨麻疹可由多种原因引起,刺激产生过敏反应,或因冷、热、因风、日光等的物理性刺激,食鱼虾等敏感性食物。目前来说,抗组胺药物仍是一线用药,但对于一些特殊人群不适用该药物,比如高空作业的人群、专职驾驶员、外科医生以及运动员等,这与抗组胺药物会造成注意力无法集中以及影响肌肉代谢,从而影响正常生活工作学习有关。”

奥马珠单抗,新型疗法迎来重大突破

“随着近年来研究的深入,对慢性荨麻疹的认识有了较大的变化,也使治疗的理念不断更新。非抗组胺药已成为治疗荨麻疹的新型疗法,比如奥马珠单抗。奥马珠单抗是一种针对CSU关键发病环节IgE的新型生物制剂,在中国III期临床研究中展示出良好的疗效与安全性,并且起效迅速,每月注射一次使用简便,有望为中国CSU患者提供更好的治疗手段,期待中国的患者能从中获益。”

在这项由郑捷教授牵头的III期研究采用多中心、随机、双盲、安慰剂对照设计,入组中国患者418例,旨在评估奥马珠单抗150mg和300mg在中国CSU患者中的疗效和安全性。

研究结果显示:

1. 奥马珠单抗300mg和150mg治疗12周均可显著降低患者每周瘙痒严重程度;

2. 治疗12周时疾病活动度显著降低,患者生活质量得到提升,总体耐受性和安全性良好。

据悉,奥马珠单抗已在全球多个国家和地区获批用于慢性自发性荨麻疹(CSU)和慢性特发性荨麻疹(CIU)的治疗(CSU在美国和加拿大被称为CIU)。目前,奥马珠单抗已被国际指南推荐用于抗组胺药治疗后仍有症状的患者。

2018版《中国荨麻疹诊疗指南》也提出, 对于慢性荨麻疹患者,如对一线、二线抗组胺药物治 疗无效,三线治疗可考虑选择生物制剂,如奥马珠单抗,对多数难治性荨麻疹有较好疗效。

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    2021-05-22 zhaojie88
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    2021-05-22 sodoo
  5. [GetPortalCommentsPageByObjectIdResponse(id=1924883, encodeId=66ce19248834a, content=<a href='/topic/show?id=7d1558259f5' target=_blank style='color:#2F92EE;'>#新型疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58259, encryptionId=7d1558259f5, topicName=新型疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Thu Dec 23 17:39:55 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355597, encodeId=45fd135559e53, content=<a href='/topic/show?id=0ff310302082' target=_blank style='color:#2F92EE;'>#麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103020, encryptionId=0ff310302082, topicName=麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378795, encodeId=020d13e87953d, content=<a href='/topic/show?id=f263536e74f' target=_blank style='color:#2F92EE;'>#慢性自发性荨麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53677, encryptionId=f263536e74f, topicName=慢性自发性荨麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5319428, createdName=jjjiang0199, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530631, encodeId=ff3c1530631c6, content=<a href='/topic/show?id=ed4a860e872' target=_blank style='color:#2F92EE;'>#自发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86078, encryptionId=ed4a860e872, topicName=自发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584a12117168, createdName=sodoo, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967237, encodeId=ed5b96e237b1, content=可以,我也是慢性荨麻疹之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=692d5505184, createdName=ms8000000777982166, createdTime=Thu May 20 15:29:46 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967185, encodeId=634796e18553, content=“中国慢性荨麻疹发病率为1.5%,也就是说每100个人当中就有1.5个人患有慢性荨麻疹”— 是否需要明确下到底是发病率还是患病率?, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dfba5504594, createdName=ms5000000912788906, createdTime=Thu May 20 10:51:20 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967180, encodeId=a53d96e1806a, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ee5467440, createdName=ms4000000749026929, createdTime=Thu May 20 10:28:40 CST 2021, time=2021-05-20, status=1, ipAttribution=)]
    2021-05-20 ms8000000777982166

    可以,我也是慢性荨麻疹之一

    1

    展开1条回复
  6. [GetPortalCommentsPageByObjectIdResponse(id=1924883, encodeId=66ce19248834a, content=<a href='/topic/show?id=7d1558259f5' target=_blank style='color:#2F92EE;'>#新型疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58259, encryptionId=7d1558259f5, topicName=新型疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Thu Dec 23 17:39:55 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355597, encodeId=45fd135559e53, content=<a href='/topic/show?id=0ff310302082' target=_blank style='color:#2F92EE;'>#麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103020, encryptionId=0ff310302082, topicName=麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378795, encodeId=020d13e87953d, content=<a href='/topic/show?id=f263536e74f' target=_blank style='color:#2F92EE;'>#慢性自发性荨麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53677, encryptionId=f263536e74f, topicName=慢性自发性荨麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5319428, createdName=jjjiang0199, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530631, encodeId=ff3c1530631c6, content=<a href='/topic/show?id=ed4a860e872' target=_blank style='color:#2F92EE;'>#自发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86078, encryptionId=ed4a860e872, topicName=自发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584a12117168, createdName=sodoo, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967237, encodeId=ed5b96e237b1, content=可以,我也是慢性荨麻疹之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=692d5505184, createdName=ms8000000777982166, createdTime=Thu May 20 15:29:46 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967185, encodeId=634796e18553, content=“中国慢性荨麻疹发病率为1.5%,也就是说每100个人当中就有1.5个人患有慢性荨麻疹”— 是否需要明确下到底是发病率还是患病率?, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dfba5504594, createdName=ms5000000912788906, createdTime=Thu May 20 10:51:20 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967180, encodeId=a53d96e1806a, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ee5467440, createdName=ms4000000749026929, createdTime=Thu May 20 10:28:40 CST 2021, time=2021-05-20, status=1, ipAttribution=)]
    2021-05-20 ms5000000912788906

    “中国慢性荨麻疹发病率为1.5%,也就是说每100个人当中就有1.5个人患有慢性荨麻疹”— 是否需要明确下到底是发病率还是患病率?

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1924883, encodeId=66ce19248834a, content=<a href='/topic/show?id=7d1558259f5' target=_blank style='color:#2F92EE;'>#新型疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58259, encryptionId=7d1558259f5, topicName=新型疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Thu Dec 23 17:39:55 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355597, encodeId=45fd135559e53, content=<a href='/topic/show?id=0ff310302082' target=_blank style='color:#2F92EE;'>#麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103020, encryptionId=0ff310302082, topicName=麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378795, encodeId=020d13e87953d, content=<a href='/topic/show?id=f263536e74f' target=_blank style='color:#2F92EE;'>#慢性自发性荨麻疹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53677, encryptionId=f263536e74f, topicName=慢性自发性荨麻疹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5319428, createdName=jjjiang0199, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530631, encodeId=ff3c1530631c6, content=<a href='/topic/show?id=ed4a860e872' target=_blank style='color:#2F92EE;'>#自发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86078, encryptionId=ed4a860e872, topicName=自发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584a12117168, createdName=sodoo, createdTime=Sat May 22 00:39:55 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967237, encodeId=ed5b96e237b1, content=可以,我也是慢性荨麻疹之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=692d5505184, createdName=ms8000000777982166, createdTime=Thu May 20 15:29:46 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967185, encodeId=634796e18553, content=“中国慢性荨麻疹发病率为1.5%,也就是说每100个人当中就有1.5个人患有慢性荨麻疹”— 是否需要明确下到底是发病率还是患病率?, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dfba5504594, createdName=ms5000000912788906, createdTime=Thu May 20 10:51:20 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967180, encodeId=a53d96e1806a, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ee5467440, createdName=ms4000000749026929, createdTime=Thu May 20 10:28:40 CST 2021, time=2021-05-20, status=1, ipAttribution=)]
    2021-05-20 ms4000000749026929

    学习学习

    0

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