NHS批准的新型哮喘药物dupilumab被称为“神奇药物”

2021-10-18 Allan MedSci原创

与接受安慰剂的患者相比,接受dupilumab治疗的患者的严重哮喘发作率显著降低(严重哮喘发作年化率:dupilumab vs. 安慰剂 0.37 vs. 1.08),并且肺功能和哮喘控制也更好。

哮喘是常见的气道慢性炎症疾病,主要特征是多变和复发的症状、可逆性气流阻塞,和支气管痉挛。常见症状表现为喘息、咳嗽、胸腔紧迫、胸闷和呼吸困难。哮喘是一种影响英国超过500万人的疾病。近日,英国NICE发布了最终评估决定(FAD),推荐dupilumab作为严重哮喘的附加维持治疗。

Dupilumab是一种白介素 4 (IL-4) 受体 α 拮抗剂,通过特异性结合 IL-4 受体 α 亚基来抑制 IL-4 和白细胞介素 13 (IL-13) 信号。Dupilumab抑制IL-4和IL-13细胞因子诱导的反应,包括促炎细胞因子、趋化因子和免疫球蛋白E的释放。Dupilumab将通过注射提供给患者,这些注射剂每隔几周进行一次,临床试验表明,当与标准吸入器结合使用时,可显著降低哮喘发作的频率。

一项研究显示,与接受安慰剂的患者相比,接受dupilumab治疗的患者的严重哮喘发作率显著降低(严重哮喘发作年化率:dupilumab vs. 安慰剂 0.37 vs. 1.08),并且肺功能和哮喘控制也更好(图1)。在嗜酸性粒细胞基线水平较高的患者中观察到更大的临床获益,但在一些患者中观察到嗜酸性粒细胞增多。

图1.在意向治疗人群中,FEV1从基线的变化

接受治疗和获得治疗的人的标准是严格的,Dupilumab适用于患有2型炎症以及在去年至少有四次严重哮喘发作的人。

英国哮喘协会和英国肺脏基金会合作伙伴研究与创新总监Samantha Walker博士说:“虽然NICE推荐dupilumab的决定值得庆祝,但可悲的事实是,五分之四的疑似严重哮喘患者没有被转诊,以寻求可以改变甚至挽救他们生命的治疗方法”。

 

原始出处:

http://www.pharmatimes.com/news/new_asthma_drug_approved_on_nhs_branded_a_wonder_drug_1381090

评论区 (6)
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    2022-09-20 snf701207

    #mAb#

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    2022-05-13 huangdf

    #哮喘药#

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    2021-10-20 zhyy88
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    2021-10-20 小几洁

    #NHS#

    0

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    2021-10-19 DR.Fu SIR

    邓普利珠单抗?

    0

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    2021-10-19 医者仁者

    #哮喘#未来单抗是主导

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地表强大辅助:哮喘老是治不好?益生菌或可助你一臂之力!

哮喘是一种常见的慢性炎症性呼吸系统疾病,在全球范围内具有高发病率和死亡率,其临床表现为喘息、咳嗽、胸闷、呼吸急促、呼吸困难、睡眠障碍等,并且可能诱发气胸、肺不张、慢阻肺、支气管扩张或肺源性心脏病等。

Eur Respir J:哮喘与COPD的异质性

哮喘和/或COPD患者中,医生的诊断和严重程度存在组内异质性,以及组间重叠。目前临床实践中的诊断和严重程度分类很难区分可能存在特定风险和治疗意义的临床表型。

Thorax:急性哮喘成人或儿童患者肾上腺素与选择性β-2激动剂的疗效比较

现有的低质量证据表明,肾上腺素和选择性β2-激动剂在急性哮喘中具有相似的疗效。需要高质量的双盲RCT来明确在吸入或雾化选择性β2激动剂治疗方案中加入肌注肾上腺素是否能改善结局。

警惕!氨茶碱与这些抗菌药合用会致命!

茶碱类药物主要用于治疗慢性阻塞性肺疾病和支气管哮喘,对支气管平滑肌有直接松弛作用,为常用的支气管扩张药。此外,茶碱类药物还能够兴奋呼吸中枢、增强膈肌收缩力、强心利尿、降低毛细血管张力并减少血管渗出。

靶向IL-4R单克隆抗体 (AK120) 治疗特应性皮炎和哮喘,中国II期临床试验已经启动

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本文综述深刻揭示了哮喘发病过程中氧化应激与炎症的相互作用网络,强调多靶点、多机制调控策略的重要性。

BMC Pediatrics:儿童哮喘肺功能评估新视角,我国学者揭示IgE 与 FeNO 的独立及协同影响

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大会期间,williamhill asia 医学有幸邀请到来自华中科技大学同济医学院附属同济医院刘辉国教授,围绕哮喘与睡眠呼吸障碍关系及进展进行精彩分享。

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该策略旨在实现甾体抗炎药物与抗体药物在肺部的靶向富集及协同作用,通过调控气道炎症微环境与阻断TSLP介导的2型炎症通路,为重症难治性哮喘提供兼具快速起效与免疫调节优势的创新治疗方案。

Lancet子刊:血液嗜酸细胞与 FeNO 联合预测哮喘发作风险,协同效应超越传统指标

本研究通过创新整合22项国际哮喘临床试验对照组的大规模患者级数据,系统量化了生物标志物与传统临床指标的联合发作风险预测价值,具有里程碑意义。