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A comparison of biologicals in the treatment of adults with severe asthma – real-life experiences

机译：严重哮喘治疗成人的生物学比较 - 现实生活经验

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BackgroundAnti-IgE (omalizumab) and anti-IL5/IL5R (reslizumab, mepolizumab and benralizumab) treatments are available for severe allergic and eosinophilic asthma. In these patients, studies have shown beneficial effects in oral corticosteroid use and exacerbations. The aim of this retrospective single-center study was to evaluate the effect of biological therapy on severe asthma and to compare different therapies.MethodsWe collected and analysed results of anti-IL5/IL5R and anti-IgE therapies for asthma from January 2009 until October 2019 in specialized care. We compared number of exacerbations, asthma symptoms and use of per oral corticosteroids and antimicrobics because of asthma before and during biological therapy, and in a separate analysis need for per oral corticosteroids, antimicrobics or surgery due to upper respiratory tract diseases in asthmatics receiving biologicals. The analyses were done using the Chi square test, T-test or Mann-Whitney U -test, the Kruskall-Wallis test or the Wilcoxon test.ResultsOf 64 patients, 40 used continuous per oral corticosteroid therapy prior to biological therapy. The mean daily dose of per oral corticosteroid was reduced in those with anti-IL5/IL5R therapy (??3.0?mg, p =?0.02). The number of annual per oral corticosteroid courses decreased in both the anti-IL5/IL5R (??2.8 courses, p ?0.05) and anti-IgE groups (??1.3 courses, p ?0.05). The number of annual antibiotic courses (??0.7 courses, p =?0.04) and total number of exacerbation events (??4.4 events/year, p ?0.05) were reduced in the anti-IL5/IL5R group. In the 55 asthma patients analysed for upper respiratory tract findings, the results suggested a reduction in need for chronic rhinosinusitis surgery during biological therapy.ConclusionsResults with biological therapies in this real-life clinical setting are comparable to those reported in clinical trials. Biological therapy reduces exacerbations and per oral corticosteroid use.
机译：Backgroundanti-IgE（omalizumab）和抗IL5 / IL5R（Reslizumab，Mepolizumab和Benralizumab）治疗可用于严重过敏和嗜酸性嗜嗜酸性哮喘。在这些患者中，研究表明口腔皮质类固醇使用和加剧中的有益效果。该回顾性单中心研究的目的是评估生物治疗对严重哮喘的影响，并比较不同的治疗方法。近期从2009年1月到2019年10月的哮喘收集和分析抗IL5 / IL5R和抗IgE疗法的结果在专业护理。我们在生物疗法之前和期间比较了每种口腔皮质类固醇和抗微生物的次数，哮喘症状和抗微生物的数量，并且在哮喘的上呼吸道疾病接受生物学的上呼吸道疾病的单独分析，抗微生物或手术的单独分析需要。通过志方检验，T检验或Mann-Whitney U -Test，Kruskall-Wallis试验或Wilcoxon Test.Resultsof，40例患者，40例在生物疗法之前连续使用，40例持续使用。在抗IL5 / IL5R治疗的那些中，每次口服皮质类固醇的平均每日剂量减少（3.0×mg，p = 0.02）。抗IL5 / IL5R（22.8课程，P <0.05）和抗IgE组（21.3课程，P <0.05）减少了每年每月皮质类固醇课程的数量减少。在抗IL5 / IL5R组中，每年抗生素课程（?? 0.7课程，P = 0.04）和加重事件总数（？4.4事件/年，P <0.05）。在55例哮喘患者中分析上呼吸道调查结果，结果表明生物治疗期间慢性鼻窦炎手术的需要减少。在这种现实生活中具有生物疗法的生物疗法的组合结果与临床试验中报道的患者。生物疗法减少了恶化和每个口服皮质类固醇使用。

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