识别重度未控制哮喘患者对度普利尤单抗超级应答的预测性基线特征

文献信息

中文摘要

度普利尤单抗是一种作用于2型炎症通路的IgG4人源单克隆抗体。已显示其通过减少急性发作和改善症状控制对重度哮喘患者产生显著影响。一部分患者在开始度普利尤单抗治疗12个月内症状控制极佳且急性发作消除，被称为超级应答者。在此，我们回顾性识别单中心真实生活中使用度普利尤单抗的患者，以审查基线特征，比较实现超级应答者与未实现者。共纳入48例患者，其中23例符合超级应答标准。在平均（95%CI）基线嗜酸性粒细胞（343个/µL（9, 677）p < 0.05）和FeNO（32.18ppb（0.88, 63.48）p < 0.05）之间观察到显著差异。此外，发现超级应答与鼻息肉相关（卡方 -5.88，p < 0.05）。总之，重度哮喘患者对度普利尤单抗的超级应答与嗜酸性粒细胞和FeNO升高以及鼻息肉的存在相关。

英文摘要

Dupilumab is an IgG4 human monoclonal antibody which acts upon the type 2 inflammatory pathway. It has been shown to have a significant impact on patients with severe asthma through reducing exacerbations and improving symptom control. A subgroup of patients experiences excellent symptom control and elimination of exacerbations within 12 months of starting dupilumab and are termed super responders. Here we retrospectively identify real-life patients on dupilumab at a single centre to review the baseline characterises comparing those who achieve super response against those that do not. 48 patients were included with 23 fulfilling criteria for super response. Significant differences were seen between the mean (95%CI) baseline eosinophils (343cells/µL (9, 677) p < 0.05) and FeNO (32.18ppb (0.88, 63.48) p < 0.05). Additionally, super-response was found to be associated with nasal polyps (chi squared -5.88, p < 0.05). In conclusion, super response to dupilumab in patients with severe asthma was associated with raised eosinophils and FeNO along side the presence of nasal polyps.