哮喘生物制剂与呼吸道感染风险
Risk of Respiratory Tract Infections with Asthma Biologics.
文献信息
| PMID | 42785633 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Shane Stone |
| 作者单位 | Section of Allergy, Asthma, & Immunology, Penn State College of Medicine, Hershey, Pennsylvania. |
| 期刊 | The journal of allergy and clinical immunology. In practice |
| SCI 分区 | Q1 |
| IF | 7.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 哮喘生物制剂可能因2型（T2）通路在免疫稳态中的作用而增加感染风险。尽管临床试验已显示良好的安全性特征，但支持这些发现的真实世界数据有限。
目的： 描述使用哮喘生物制剂相关的呼吸道感染风险特征。
方法： 这项回顾性匹配队列研究利用TriNetX美国协作网络（一个多中心电子健康记录数据库），检查了年龄≥6岁、患有中重度哮喘且暴露于哮喘生物制剂的患者，并与无此类暴露的对照进行比较。研究队列随访长达2年，生存分析对比了发生各种呼吸道感染的概率。风险比（HR）量化了这种相互作用的幅度和方向。
结果： 与匹配对照相比，暴露于任何哮喘生物制剂与发生呼吸道感染的风险增加无关，并且发生流感（HR 0.80，95% CI=0.69-0.94）和急性上呼吸道感染（URI）（HR=0.93，95% CI：0.87-0.99）的概率较低。度普利尤单抗暴露与发生急性URI（HR=0.79，95% CI：0.69-0.91）、肺炎（HR=0.72，95% CI：0.58-0.90）和流感（HR=0.53，95% CI：0.36-0.80）的概率较低相关。抗IL5使用者发生急性URI相对较少（HR=0.88，95% CI：0.79-0.97）。奥马珠单抗或特泽鲁单抗暴露相关的呼吸道感染风险无显著差异。
结论： 尽管需要针对特定病原体和通路的进一步研究，但哮喘生物制剂与呼吸道感染风险升高无关。度普利尤单抗可能降低某些呼吸道感染的风险。
英文摘要
BACKGROUND: Asthma biologics may increase infection risk due to the role of type-2 (T2) pathways in immune homeostasis. While clinical trials have demonstrated favorable safety profiles, limited real-world data exists to support these findings.
OBJECTIVE: To characterize the risk of respiratory tract infections associated with using asthma biologics.
METHODS: This retrospective matched cohort study utilizing the TriNetX US Collaborative Network, a multicenter database of electronic health records, examined patients (age ≥6 years) with moderate-to-severe asthma who had exposure to an asthma biologic against controls without such exposure. Study cohorts were followed for up to 2 years and survival analysis contrasted the probability of developing various respiratory tract infections. The hazards ratio (HR) quantified the magnitude and direction of this interaction.
RESULTS: As compared to matched controls, exposure to any asthma biologic was not associated with increased hazards of developing respiratory tract infections and lower probabilities of developing influenza (HR 0.80, 95% CI=0.69-0.94) and acute upper respiratory tract infections (URIs) (HR=0.93, 95% CI: 0.87-0.99). Dupilumab exposure was associated with lower probability of developing acute URI (HR=0.79, 95% CI: 0.69-0.91), pneumonia (HR=0.72, 95% CI: 0.58-0.90), and influenza (HR=0.53, 95% CI: 0.36-0.80). Anti-IL5 users had relatively fewer acute URIs (HR=0.88, 95% CI: 0.79-0.97). There was no significant difference in respiratory tract infection risk associated with omalizumab or tezepelumab exposure.
CONCLUSIONS: Although further studies focusing on specific pathogens and pathways are needed, asthma biologics are not associated with a higher risk of respiratory infections. Dupilumab might reduce the risk of certain respiratory tract infections.