Annals of Allergy Asthma & Immunology最新文献

英文中文

Impact of varying childhood asthma definitions on incidence and clinical outcomes 不同儿童哮喘定义对发病率和临床结果的影响。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-02-01 Epub Date: 2025-08-14 DOI: 10.1016/j.anai.2025.08.006

Amir Ghabousian MD, Gisele N. Bezerra MD, Zhaozhong Zhu SCD, Janice A. Espinola MPH, Ashley F. Sullivan MS, MPH, Carlos A. Camargo Jr MD, DrPH

Background

The absence of a standardized asthma definition in epidemiologic studies undermines the consistency of incidence estimates and the comparability of clinical outcomes.

Objective

To evaluate the impact of integrating bronchodilator response (BDR) into parent-reported asthma definitions by comparing incidence, disease severity, control, and diagnostic performance across these definitions, and to assess the individual diagnostic performance of BDR and fractional exhaled nitric oxide in identifying asthma cases.

Methods

We used data from a prospective cohort of 919 infants with severe (hospitalized) bronchiolitis to explore 4 asthma definitions: (1) broad, any physician diagnosis of asthma by age 6 years, as reported by parents; (2) epidemiologic, definition 1 plus either asthma medication use (eg, inhaled bronchodilator, inhaled corticosteroid, systemic corticosteroid, and montelukast) or asthma-related symptoms between ages 5.0 and 5.9 years; (3) alternative strict, definition 2 plus a post-BDR increase of 8% or greater in predicted forced expiratory volume in 1 second; and (4) strict, definition 2 plus a post-bronchodilator increase of more than 10% in predicted forced expiratory volume in 1 second. Outcomes were assessed across these definitions, and their diagnostic performance was compared with a physician reviewer’s asthma diagnosis (reference standard).

Results

The incidence rates for the 4 definitions were 37.2%, 27.7%, 13.2%, and 9.3%, respectively, with intermittent asthma severity classification following a similar pattern (72.4%, 65.5%, 56.0%, and 52.8%). Transitioning from the first to the fourth definition improved specificity and positive predictive value but reduced sensitivity, with no consistent trends being observed for asthma control across definitions.

Conclusion

These findings suggest that incorporating BDR into parent-reported asthma definitions underestimates asthma incidence and identifies cases with worse clinical outcomes.

背景：流行病学研究中缺乏标准化的哮喘定义破坏了发病率估计的一致性和临床结果的可比性。目的：我们通过比较这些定义的发病率、疾病严重程度、控制和诊断表现，评估将支气管扩张剂反应（BDR）纳入父母报告的哮喘定义的影响。我们还评估了BDR和分数呼气一氧化氮（FeNO）在识别哮喘病例中的个体诊断性能。方法：我们利用919例重症（住院）毛细支气管炎婴儿的前瞻性队列数据，探讨四种哮喘定义：1)广泛的，任何医生诊断的哮喘，在6岁时，由父母报告；2)流行病学，定义1加上哮喘药物使用（例如，吸入支气管扩张剂、吸入皮质类固醇、全身皮质类固醇、孟鲁司特）或哮喘相关症状，年龄在5.0-5.9岁之间；3)另一种严格的定义2加上支气管扩张剂后预测1秒用力呼气量（FEV1）增加≥8%；4)严格定义2加上支气管扩张剂后预测FEV1增加10%。通过这些定义评估结果，并将其诊断性能与医师审稿人的哮喘诊断（参考标准）进行比较。结果：四种定义的发病率分别为37.2%、27.7%、13.2%和9.3%，间歇性哮喘的严重程度分类也有相似的模式（72.4%、65.5%、56.0%和52.8%）。从第一种定义过渡到第四种定义提高了特异性和阳性预测值，但降低了敏感性，在不同定义的哮喘控制方面没有观察到一致的趋势。结论：这些发现表明，将BDR纳入父母报告的哮喘定义低估了哮喘发病率，并识别出临床结果较差的病例。

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引用次数: 0

Sex-based differences in perioperative hypersensitivity 围手术期超敏反应的性别差异：系统回顾和荟萃分析。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-02-01 Epub Date: 2025-10-24 DOI: 10.1016/j.anai.2025.10.012

Ricardo J. Estrada-Mendizabal MD , Payge Moraca DO , Alfonso J. Castillo-Ivon , Jennifer Priessnitz MD , Ebram N. Labib MD , Saiyara S. Shama MBBS , Nisha B. Patel MD , Lisa A. Marks MLS, AHIP , Sergio E. Chiarella MD , Vito Sabato MD , Christine R.F. Rukasin MD , Gerald W. Volcheck MD , Alexei Gonzalez-Estrada MD

Background

Perioperative hypersensitivity (POH) is a rare, immediate hypersensitivity reaction. Its more severe form, perioperative anaphylaxis, has a 2% mortality rate. Sex is a biological variable that can affect the immune response, but its role in POH remains unclear. We aimed to assess sex-based differences in POH and explore potential differences by age, culprit drugs, and reaction severity.

Objective

To systematically assess sex-based differences in the proportion of POH and assess variations by age group, suspected culprit drugs, and reaction severity.

Methods

A systematic search was conducted in MEDLINE, EMBASE, Scopus, and Web of Science. Cohort, retrospective, prospective, and cross-sectional studies reporting the female-to-male ratio of POH patients were included. A proportional meta-analysis using an inverse-variance method with logit transformation was performed to calculate pooled sex proportions. Subgroup analyses were conducted based on age, culprit drugs, and severity grading.

Results

A total of 62 studies comprising 19,944 patients (63% female) were included. The pooled proportion of female-to-male patients with POH was 0.60 (95% CI: 0.57-0.63; 95% prediction interval: 0.40-0.78). Subgroup analysis revealed a higher female predominance in adults, 0.59 (95% CI: 0.55-0.62), whereas males predominated in pediatric studies (0.41; 95% CI: 0.36-0.47).

Conclusion

We found a female predominance of POH overall, though males had a higher proportion in pediatric studies, possibly due to chromosomal factors influencing POH rates before adolescence. In adulthood, hormonal changes may contribute to the observed female predominance. Further research is needed to explore the mechanisms behind the observed differences.

背景：围手术期超敏反应（POH）是一种罕见的即时超敏反应。其更严重的形式，围手术期过敏反应，死亡率为2%。性别是影响免疫反应的生物学变量，但其在POH中的作用尚不清楚。我们的目的是评估POH的性别差异，并探讨年龄、罪魁祸首药物和反应严重程度的潜在差异。目的：系统评估围手术期超敏反应比例的性别差异，并评估不同年龄组、疑似元凶药物和反应严重程度的差异。方法：系统检索MEDLINE、EMBASE、Scopus、Web of Science。纳入了报告POH患者男女比例的队列、回顾性、前瞻性和横断面研究。采用logit变换的反方差法进行比例荟萃分析，计算合并性别比例。根据年龄、罪魁祸首药物和严重程度分级进行亚组分析。结果：纳入63项研究，包括19,981例患者（62%为女性）。POH患者男女比例合计为0.60 （95% CI: 0.57-0.63； 95%预测区间：0.40-0.77）。亚组分析显示，在成人研究中，女性优势较高，为0.58 (95% CI: 0.54-0.62)，而在儿科研究中，男性优势较高（0.41,95% CI: 0.36-0.46）。结论：我们发现POH总体上以女性为主，尽管在儿科研究中男性的比例更高，可能是由于染色体因素影响青春期前的POH发病率。在成年期，激素的变化可能导致观察到的女性优势。需要进一步的研究来探索所观察到的差异背后的机制。

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引用次数: 0

Severe food protein-induced enterocolitis syndrome with seizures and concern for developmental delay: A case report 严重食物蛋白诱导的肠结肠炎综合征伴癫痫发作并关注发育迟缓：1例报告。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-02-01 Epub Date: 2025-11-04 DOI: 10.1016/j.anai.2025.10.028

Benjamin Martinez MD , Shatha Alhamdi MBBS , Julia E.M. Upton MD, MPH

引用次数: 0

Information for Readers 读者资讯

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-02-01 Epub Date: 2026-02-02 DOI: 10.1016/S1081-1206(25)01403-6

引用次数: 0

Author’s response 作者的回应

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-02-01 Epub Date: 2026-02-02 DOI: 10.1016/j.anai.2025.10.006

Jonathan A. Bernstein MD

引用次数: 0

Epithelial histone deacetylase 7 (HDAC7) constitutes a negative feedback loop restraining interleukin (IL)-13-driven eosinophilic inflammation in chronic rhinosinusitis. 在慢性鼻窦炎中，上皮细胞HDAC7构成一个负反馈回路，抑制il -13驱动的嗜酸性粒细胞炎症。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-01-30 DOI: 10.1016/j.anai.2026.01.013

Xiwen Sun, Wenqin Liu, Yueming Cui, Haoyan Guan, Yueqi Sun, Rui Xu

Background: Epithelial dysfunction is a central driver of type 2 inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP). Although epigenetic mechanisms are known to regulate mucosal immunity, the specific role of histone deacetylase 7 (HDAC7) in modulating the magnitude of epithelial type 2 responses remains unclear. We hypothesized that HDAC7 functions as an inducible checkpoint to restrain excessive inflammation.

Objective: To explore the role of epithelial HDAC7 in restraining excessive inflammation in CRSwNP.

Methods: Primary human nasal epithelial cells were exposed to inflammatory stimuli to identify HDAC7 inducers. Epithelial HDAC7 expression in patient tissues was correlated with inflammatory markers and remodeling indices. Mechanistic roles were assessed using lentiviral knockdown, transcriptome sequencing, and eosinophil chemotaxis assays.

Results: Interleukin (IL)-13 selectively induced epithelial HDAC7 expression. In clinical tissues, lower HDAC7 expression within the CRSwNP cohort correlated with severe type 2 inflammation and mucosal remodeling. Transcriptomic analysis revealed that HDAC7-low tissues demonstrated enriched type 2 pathways, whereas high expression aligned with T_H1/T_H17 signatures. In vitro, silencing HDAC7 amplified the broader IL-13-induced transcriptional program and specifically enhanced C-C motif chemokine ligand 26 (CCL26) production, promoting C-C chemokine receptor type 3-dependent eosinophil migration. Notably, this effect appeared specific to HDAC7 loss, as broad-spectrum HDAC inhibition with trichostatin A suppressed CCL26 and did not recapitulate the knockdown phenotype.

Conclusion: HDAC7 appears to function as an inducible negative regulator in the nasal epithelium, attenuating IL-13-driven CCL26 production. Disruption of this feedback loop may contribute to exacerbated type 2 inflammation, suggesting epithelial HDAC7 as a potential biomarker and therapeutic target for CRSwNP.

背景：上皮功能障碍是慢性鼻窦炎伴鼻息肉（CRSwNP） 2型炎症的主要驱动因素。虽然表观遗传机制调节粘膜免疫是已知的，但组蛋白去乙酰化酶7 （HDAC7）在调节上皮2型应答中的具体作用仍不清楚。我们假设HDAC7作为一个诱导检查点来抑制过度炎症。目的：探讨上皮细胞HDAC7在抑制CRSwNP过度炎症中的作用。方法：将原代人鼻上皮细胞暴露于炎症刺激下鉴定HDAC7诱导剂。患者组织上皮HDAC7表达与炎症标志物和重塑指标相关。通过慢病毒敲除、转录组测序和嗜酸性粒细胞趋化分析来评估机制作用。结果：白细胞介素(IL)-13选择性诱导上皮细胞HDAC7表达。在临床组织中，CRSwNP队列中HDAC7的低表达与严重的2型炎症和粘膜重塑相关。转录组学分析显示，hdac7低的组织表现出丰富的2型通路，而高表达与TH1/TH17特征一致。在体外，沉默HDAC7扩增了il -13诱导的更广泛的转录程序，特异性地增强了C-C基序趋化因子配体26 （CCL26）的产生，促进了C-C趋化因子受体3型依赖的嗜酸性粒细胞迁移。值得注意的是，这种效应似乎是HDAC7缺失所特有的，因为曲古菌素A对HDAC的广谱抑制抑制了CCL26，并且没有重现敲低表型。结论：HDAC7在鼻上皮中作为一种可诱导的负调节因子，可减弱il -13驱动的CCL26的产生。这种反馈回路的破坏可能导致2型炎症加剧，这表明上皮HDAC7是CRSwNP的潜在生物标志物和治疗靶点。

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引用次数: 0

Effect of long noncoding RNA plasmacytoma variant translocation 1 (PVT1) on epithelial barrier in chronic rhinosinusitis with nasal polyps. 长链非编码RNA PVT1对慢性鼻窦炎伴鼻息肉上皮屏障的影响。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-01-30 DOI: 10.1016/j.anai.2026.01.015

Shenting Li, Baodan Zhang, Qiqi Wang, Su Duan, Luo Zhang

引用次数: 0

Timing of cow's milk oral immunotherapy and adverse reactions in children: A 15-year experience. 奶牛mİlk口服免疫治疗的时机和儿童不良反应：15年的经验。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-01-28 DOI: 10.1016/j.anai.2026.01.016

Ezgi Topyildiz, Handan Duman Senol, Figen Gulen, Esen Demir

Background: Cow's milk allergy (CMA) is one of the most common food allergies in children and may persist into later childhood. Oral immunotherapy (OIT) is an effective treatment option; however, the optimal timing of initiation and the mechanisms underlying age-related differences in safety remain uncertain.

Objective: To evaluate the safety and efficacy of cow's milk OIT initiated at different ages and to explore the relationship between age, baseline immunologic markers, and adverse reactions in a real-world pediatric cohort.

Methods: We retrospectively analyzed 145 children with IgE-mediated CMA who completed OIT between 2009 and 2024. Patients were grouped by age at OIT initiation (<24 months, 24-48 months, and >48 months). Baseline clinical and laboratory characteristics and OIT-related adverse events (AEs) were compared. Multivariable logistic regression analyses were performed adjusting for relevant clinical covariates to assess the independent effects of age and cow's milk-specific IgE (CM-spIgE) on AEs.

Results: Older children (>48 months) had significantly higher baseline total IgE and CM-spIgE levels and more frequent pre-OIT anaphylaxis and respiratory symptoms. The use of omalizumab and epinephrine was more common in older patients. In multivariable analyses, age and CM-spIgE were each associated with adverse reactions. Early OIT (<24 months) was associated with fewer severe reactions and no anaphylaxis during the maintenance phase.

Conclusion: Earlier initiation of cow's milk OIT seems to be associated with a more favorable safety profile, highly correlated with the baseline immunologic profile. These findings support personalized decision-making that includes age and immunologic markers when determining OIT timing.

背景：牛奶过敏（CMA）是儿童最常见的食物过敏之一，并可能持续到儿童后期。口服免疫疗法（OIT）是一种有效的治疗选择；然而，起始的最佳时间和与年龄相关的安全性差异的机制仍然不确定。目的：评估在不同年龄开始的牛奶OIT的安全性和有效性，并探讨在现实世界的儿科队列中年龄、基线免疫标志物和不良反应之间的关系。方法：我们回顾性分析了145名2009年至2024年间完成OIT的免疫球蛋白E （IgE）介导的CMA患儿。患者按OIT开始时的年龄（48个月）分组。比较基线临床和实验室特征以及oit相关不良事件（ae）。对相关临床协变量进行多变量logistic回归分析，以评估年龄和牛奶特异性IgE （CM-spIgE）对ae的独立影响。结果：年龄较大的儿童（bb0 - 48个月）有较高的基线总IgE和CM-spIgE水平，更频繁的oit前过敏反应和呼吸道症状。奥玛珠单抗和肾上腺素的使用在老年患者中更为常见。在多变量分析中，年龄和CM-spIgE均与不良反应相关。结论：较早开始牛奶OIT似乎与更有利的安全性相关，与基线免疫状况高度相关。这些发现支持个性化决策，包括年龄和免疫标记，当确定OIT时机。

{"title":"Timing of cow's milk oral immunotherapy and adverse reactions in children: A 15-year experience.","authors":"Ezgi Topyildiz, Handan Duman Senol, Figen Gulen, Esen Demir","doi":"10.1016/j.anai.2026.01.016","DOIUrl":"10.1016/j.anai.2026.01.016","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk allergy (CMA) is one of the most common food allergies in children and may persist into later childhood. Oral immunotherapy (OIT) is an effective treatment option; however, the optimal timing of initiation and the mechanisms underlying age-related differences in safety remain uncertain.</p><p><strong>Objective: </strong>To evaluate the safety and efficacy of cow's milk OIT initiated at different ages and to explore the relationship between age, baseline immunologic markers, and adverse reactions in a real-world pediatric cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 145 children with IgE-mediated CMA who completed OIT between 2009 and 2024. Patients were grouped by age at OIT initiation (<24 months, 24-48 months, and >48 months). Baseline clinical and laboratory characteristics and OIT-related adverse events (AEs) were compared. Multivariable logistic regression analyses were performed adjusting for relevant clinical covariates to assess the independent effects of age and cow's milk-specific IgE (CM-spIgE) on AEs.</p><p><strong>Results: </strong>Older children (>48 months) had significantly higher baseline total IgE and CM-spIgE levels and more frequent pre-OIT anaphylaxis and respiratory symptoms. The use of omalizumab and epinephrine was more common in older patients. In multivariable analyses, age and CM-spIgE were each associated with adverse reactions. Early OIT (<24 months) was associated with fewer severe reactions and no anaphylaxis during the maintenance phase.</p><p><strong>Conclusion: </strong>Earlier initiation of cow's milk OIT seems to be associated with a more favorable safety profile, highly correlated with the baseline immunologic profile. These findings support personalized decision-making that includes age and immunologic markers when determining OIT timing.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dupilumab treatment restores epithelial barrier in nonlesional and lesional skin in children with atopic dermatitis. Dupilumab治疗可恢复特应性皮炎患儿非病变性和病变性皮肤的上皮屏障。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-01-27 DOI: 10.1016/j.anai.2026.01.008

Michael J Cork, Peck Y Ong, Simon G Danby, Robert A Byers, Stephen J Matcher, Oludolapo S Katibi, Kirsty Brown, Paul V Andrew, Abigail Pinnock, Anna Poyner, Laura Johnson, Stuart Gormley, Alison Hyde, Marco Ramirez-Gama, Shannon Garcia, Patricia A Taylor, Gabriel Bologna, Amy H Praestgaard, Joseph Zahn, Annie Zhang, Donald Y M Leung

Background: Skin barrier dysfunction and inflammation characterize both lesional and nonlesional skin in moderate-to-severe atopic dermatitis (AD) and are associated with relapses and atopic march progression.

Objective: To assess the effects of dupilumab treatment on skin barrier function and integrity using noninvasive methods in children aged 6 to 11 years with moderate-to-severe AD compared with matched healthy volunteers.

Methods: Patients received dupilumab for 16 weeks. Transepidermal water loss (TEWL) before (basal) and after skin tape stripping and epidermal thickness (T_E), measured by optical coherence tomography, were assessed to week 28.

Results: The PEdiatric skin barrier function and LIpidomics STudy in patients with Atopic Dermatitis (PELISTAD) enrolled 23 patients and 18 healthy volunteers. Mean ± SD basal TEWL was significantly higher in AD lesional/nonlesional skin at baseline (55.1 ± 5.5/28.0 ± 3.1 g × m^-2 × h^-1) than in healthy skin (14.0 ± 1.6) and decreased to 30.3 ± 3.1/22.0 ± 2.6 at week 16 and to 29.7 ± 4.3/18.3 ± 2.1 at week 28; TEWL after 5 of 20 skin tape stripping improved similarly. Baseline mean ± SD T_E in lesional/nonlesional skin (251.1 ± 25.8/166.1 ± 15.2 µm) was significantly higher than in healthy skin (118.2 ± 5.1) and decreased to 196.8 ± 18.4/141.9 ± 11.9 at week 16 and to 160.4 ± 12.9/142.7 ± 15.6 at week 28. At weeks 16 and 28, there was no significant difference between TEWL and epidermal thickness in AD lesional and nonlesional skin vs healthy skin.

Conclusion: Using noninvasive techniques to monitor epithelial function, dupilumab treatment restored skin barrier function in children with AD. Improvements achieved at week 16 were sustained to week 28.

Trial registration: ClinicalTrials.gov Identifier: PELISTAD (NCT04718870).

背景：皮肤屏障功能障碍和炎症是中重度特应性皮炎（AD）病变和非病变皮肤的特征，并与复发和特应性进展相关。目的：与匹配的健康志愿者相比，评估dupilumab治疗对6-11岁中重度AD儿童皮肤屏障功能和完整性的影响。方法：患者接受dupilumab治疗16周。通过光学相干断层扫描评估皮肤剥离（STS）前（基底）和之后的经皮失水（TEWL）以及表皮厚度（TE），一直持续到第28周。结果：PELISTAD招募了23名患者和18名健康志愿者。在基线时，AD病变/非病变皮肤的平均±SD基础TEWL（55.1±5.5/28.0±3.1 g × m-2 × h-1）显著高于健康皮肤（14.0±1.6），在第16周降至30.3±3.1/22.0±2.6，在第28周降至29.7±4.3/18.3±2.1；5/20 STS后TEWL也有类似改善。病变/非病变皮肤基线平均±SD TE（251.1±25.8/166.1±15.2µm）显著高于健康皮肤（118.2±5.1µm），第16周降至196.8±18.4/141.9±11.9，第28周降至160.4±12.9/142.7±15.6。在第16周和第28周，AD病变和非病变皮肤与健康皮肤的TEWL或TE之间没有显著差异。结论：采用无创技术监测上皮功能，dupilumab治疗可恢复AD患儿的皮肤屏障功能。第16周的改善持续到第28周。

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引用次数: 0

Bucher indirect treatment comparison of phase 3 trials with dupilumab and tezepelumab in chronic rhinosinusitis with nasal polyps. dupilumab和tezepelumab治疗慢性鼻窦炎伴鼻息肉的3期临床试验的Bucher间接治疗比较。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2026-01-22 DOI: 10.1016/j.anai.2026.01.011

Philipp Suter, Robert Greig, Brian J Lipworth

Background: Biologic therapies significantly affect clinical outcomes in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), including those with comorbid asthma. Tezepelumab and dupilumab act on upstream and downstream type 2 cytokine pathways, respectively.

Objective: To indirectly compare the relative efficacy of dupilumab with tezepelumab based on phase 3 randomized controlled trials in CRSwNP, including those with comorbid asthma.

Methods: A Bucher indirect head-to-head comparison of studies evaluating dupilumab and tezepelumab for relevant outcomes was performed.

Results: Dupilumab and tezepelumab demonstrated comparable significant improvements in endoscopic-, radiologic-, olfactory-, and symptom-based outcomes in CRSwNP. Relative differences in hazard ratios for use of oral corticosteroids and/or surgery favored tezepelumab. However, no differences were observed when considering absolute values. Dupilumab demonstrated superiority in patients with comorbid asthma for symptom control.

Conclusion: Indirect treatment comparison revealed comparable overall clinical benefits of dupilumab and tezepelumab in CRSwNP. However, a prospective head-to-head randomized controlled trial would be needed to confirm their relative efficacy.

背景：生物治疗显著影响慢性鼻窦炎伴鼻息肉（CRSwNP）患者的临床结果，包括合并哮喘的患者。Tezepelumab和dupilumab分别作用于上游和下游2型细胞因子通路。目的：间接比较dupilumab和tezepelumab在包括合并哮喘的CRSwNP患者中的3期随机对照试验的相对疗效。方法：对dupilumab和tezepelumab的相关结果进行了Bucher间接头对头比较。结果：Dupilumab和tezepelumab在CRSwNP的内窥镜、放射学、嗅觉和基于症状的结果方面显示出相当显著的改善。口服皮质类固醇和/或手术的风险比的相对差异有利于tezepelumab；然而，当考虑绝对值时，没有观察到差异。Dupilumab在共病哮喘患者的症状控制中显示出优越性。结论：间接治疗比较显示dupilumab和tezepelumab在CRSwNP中的总体临床获益相当。然而，需要一项前瞻性的随机对照试验来证实它们的相对疗效。

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