中华临床免疫和变态反应杂志2024，Vol.18Issue(4)：364-369,6.DOI:10.3969/j.issn.1673-8705.2024.04.006
奥马珠单抗治疗过敏性哮喘长期疗效和减量方案的探索
Exploration of long-term efficacy and dose reduction regimen of omalizumab treatment for allergic asthma
摘要
Abstract
Objective To investigate the long-term efficacy of anti-IgE monoclonal antibody(omalizum-ab)for the treatment of allergic asthma,with or without other allergic diseases,and to compare the efficacy of two tapering schedules for omalizumab after 12 months of standard treatment.Methods A retrospective analysis was performed on 58 patients who received omalizumab treatment at the China-Japan Friendship Hospital from January 2020 to August 2022 for allergic asthma,with or without other allergic diseases.Eligibility for tapering was assessed after 12 months of standard treatment.Those eligible for tapering continued the treatment following a tapering schedule.Sixteen patients received tapering to a reduced dosage,and another 6 received extended in-terval dosing.The remaining 36 patients continued the maintenance therapy under the original dosage.Changes in the following parameters were compared before and after the standard treatment and tapering:asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1),fractional exhaled nitric oxide(FeNO),and peripheral blood eosinophil count(EOS).Results Compared with the pre-treatment values,the average ACT score in-creased from 19.40±2.56 to 24.88±0.33 after 12 months of standard omalizumab treatment(P<0.05).The FEV1 as a percentage of the predicted value(FEV1%predicted)increased from75.94±8.31%to90.96±6.39%(P<0.05).FeNO decreased from 39.28±21.64 ppb to 12.44±4.90 ppb(P<0.05).peripheral blood EOS decreased from0.64±0.26×109/L to(0.28±0.14)×109/L(P<0.05).Compared with the values immedi-ately after 12 months of standard treatment,the ACT score and FEV1 were properly controlled after 16 months of treatment with either one of the two tapering schemes.As for inflammatory markers,FeNO and peripheral blood EOS remained stable.FeNO was even lower under tapering to a reduced dosage(from 11.88±3.34 ppb to 8.89±3.02 ppb,P<0.05).Conclusion Standard omalizumab treatment effectively improved asthma control and lung function,and decreased the levels of inflammatory markers in allergic asthmawith or without other allergic diseases.For those eligible for tapering,both tapering schedules maintained good asthma control and lung function.Tapering to a re-duced dosage was more effective than extended interval dosing in reducing the level of FeNO,which is an inflamma-tory marker.However,small sample size was one of the major limitations of the present study.关键词
奥马珠单抗/过敏性哮喘/过敏性疾病/减量方案/疗效Key words
omalizumab/allergic asthma/allergic diseases/tapering schedule/efficacy引用本文复制引用
苏楠..奥马珠单抗治疗过敏性哮喘长期疗效和减量方案的探索[J].中华临床免疫和变态反应杂志,2024,18(4):364-369,6.基金项目
中国医学科学院医学与健康科技创新工程(2021-I2M-1-049) Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-049) （2021-I2M-1-049）
