美泊利单抗治疗伴重度哮喘的慢性鼻窦炎伴鼻息肉患者的真实世界两年结局
Real-world two-year outcomes of mepolizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting severe asthma.
文献信息
| PMID | 42827160 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Juan Riestra-Ayora |
| 作者单位 | Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 慢性鼻窦炎伴鼻息肉（CRSwNP）与重度哮喘常作为2型气道炎症的表现而共存。尽管美泊利单抗已在这两种疾病中显示出疗效，但关于整合气道疾病控制的长期真实世界数据仍有限。我们评估了美泊利单抗在伴重度哮喘的CRSwNP患者中2年内的长期有效性。
方法： 我们在一个三级转诊中心开展了一项纵向真实世界观察性队列研究。基线数据为回顾性收集，随访评估在6、12和24个月时前瞻性记录。基于应答的终点评估纵向改善，而疾病控制反映每次随访时疾病负担的稳定，包括双气道疾病控制。
结果： 共纳入48例患者。美泊利单抗在两个气道区域均诱导了持续改善。SNOT-22评分从65.2改善至22.1，而NPS在2年时从4.8降至1.8。ACT评分从16.6升高至22.7，急性加重率从每患者年0.7次降至0.1次，全身性糖皮质激素暴露从95.8%降至31%。联合临床-内镜CRSwNP应答在6个月、1年和2年时分别达到60.0%、75.0%和70.6%。双气道疾病控制从24.2%增加至42.1%。
结论： 美泊利单抗为CRSwNP合并重度哮喘患者提供了持续的长期获益。虽然临床应答出现较早且较常见，但整合的双气道疾病控制是逐步实现的，且仅在较小比例的患者中达到。
英文摘要
PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) and severe asthma frequently coexist as manifestations of type 2 airway inflammation. Although mepolizumab has demonstrated efficacy in both conditions, long-term real-world data on integrated airway disease control remain limited. We evaluated the long-term effectiveness of mepolizumab in patients with CRSwNP and coexisting severe asthma over 2 years.
METHODS: We conducted a longitudinal real-world observational cohort study at a tertiary referral center. Baseline data were collected retrospectively, and follow-up assessments were prospectively recorded at 6, 12, and 24 months. Response-based endpoints assessed longitudinal improvement, whereas disease control reflected stabilization of disease burden at each follow-up, including dual airway disease control.
RESULTS: 48 patients were included. Mepolizumab induced sustained improvement across both airway compartments. SNOT-22 scores improved from 65.2 to 22.1, while NPS decreased from 4.8 to 1.8 at 2 years. ACT scores increased from 16.6 to 22.7, exacerbation rates decreased from 0.7 to 0.1 events per patient-year, and systemic corticosteroid exposure decreased from 95.8% to 31%. Combined clinical-endoscopic CRSwNP response was achieved in 60.0%, 75.0%, and 70.6% at 6 months, 1 year, and 2 years, respectively. Dual airway disease control increased from 24.2% to 42.1%.
CONCLUSIONS: Mepolizumab provides sustained long-term benefit in patients with CRSwNP and severe asthma. While clinical response occurs early and frequently, integrated dual airway disease control is achieved progressively and in a smaller proportion of patients.