Immunobiologicals in severe asthma: case report

Concilium Pub Date : 2024-07-09 DOI:10.53660/clm-3669-2441a
Luis Vicente Franco Oliveira, L. R. Alves, Fernanda N. B. R. Alves, W. J. S. Pedro, K. S. I. Tabata, L. V. Braga, Flávio Vecchi Barbosa Júnior, M. C. Oliveira, Vera Lúcia Santos Alves, Roberto Stirbulov
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Abstract

According to the Global Initiative for Asthma (GINA), asthma is a chronic-inflammatory respiratory disease, characterized by limitation of expiratory air flow, dyspnea, wheezing and tachypnea, especially at night or in contact with allergens, climate changes or presence of environmental pollution. Among its subtypes, severe asthma stands out, where the symptomatic condition persists despite optimized treatment at advanced levels. The present study is a case report associated with a literature review on the use of immunobiologicals in the clinical treatment of severe asthma. Female patient, 53 years old, history of late-onset asthma at age 25, with frequent exacerbations, using drug therapy based on inhaled corticosteroid (ICS), long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) in a single inhaler associated with the use of oral corticosteroids. After confirming the diagnosis of severe non-allergic eosinophilic asthma of endotype T2, GINA 5, the patient started treatment with mepolizumab and months later she showed significant improvement with the use of the immunobiological 1x/month and use of ICS associated with LABA. 12/12h, without the need for oral corticosteroids and use of rescue medications less than 2x/week.
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重症哮喘的免疫生物学治疗:病例报告
根据全球哮喘倡议(GINA),哮喘是一种慢性炎症性呼吸道疾病,其特点是呼气流量受限、呼吸困难、喘息和呼吸急促,尤其是在夜间或接触过敏原、气候变化或存在环境污染时。在哮喘的亚型中,重症哮喘最为突出,尽管经过先进的优化治疗,但症状依然存在。本研究是一份病例报告,并对重症哮喘临床治疗中免疫生物制剂的应用进行了文献综述。女患者,53 岁,25 岁时晚期哮喘病史,病情经常加重,使用的药物疗法是将吸入式皮质类固醇(ICS)、长效 β2-受体激动剂(LABA)和长效毒蕈碱拮抗剂(LAMA)混合在一个吸入器中,同时口服皮质类固醇。在确诊为内型 T2、GINA 5 的重度非过敏性嗜酸性粒细胞哮喘后,患者开始接受美泊珠单抗治疗,几个月后,她的病情有了显著改善,免疫生物制剂每月使用 1 次,ICS 与 LABA 同时使用。12/12小时,无需口服皮质类固醇,每周使用救援药物少于2次。
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