重度哮喘使用奥马珠单抗治疗无效的患者特征

Characteristics of patients with severe asthma who do not respond to omalizumab

目的了解重度哮喘使用奥马珠单抗治疗无效的患者特征。方法选择2018年3月至2021年2月接受奥马珠单抗治疗的118例重度哮喘患者作为研究对象,比较奥马珠单抗治疗有效组和无效组的临床特征,评估与奥马珠单抗治疗失败相关的因素,并分析奥马珠单抗治疗失败后接受替代治疗患者的临床结局。结果奥马珠单抗治疗有效组和无效组的治疗时间、使用糖皮质激素、合并嗜酸性粒细胞性慢性鼻-鼻窦炎(ECRS)以及合并嗜酸粒细胞性中耳炎(EOM)情况比较,差异有统计学意义(P<0.05);Logistic回归分析发现,合并ECRS、合并EOM为奥马珠单抗治疗失败的独立影响因素(P<0.05)。结论合并ECRS、EOM可能会导致重度哮喘患者使用奥马珠单抗治疗无效,建议此类患者考虑采用抗白介素(IL)-5抗体或抗IL-5Rα抗体治疗。

Objective To learn about the characteristics of patients with severe asthma who do not respond to omalizumab.Methods A total of 118 patients with severe asthma who received omalizumab from March 2018 to February 2021 were selected as the research subjects.The clinical characteristics of the effective and ineffective groups of omalizumab treatment were compared.Factors associated with omalizumab failure were assessed,and the clinical outcomes of patients receiving replacement therapy after omalizumab failure were analyzed.Results Comparison of treatment time,glucocorticoid use,eosinophilic chronic rhinosinusitis(ECRS)and eosinophilic otitis media(EOM)between the effective and ineffective omalizumab treatment groups showed that the difference was statistically significant(P<0.05).Logistic regression analysis found that combination with ECRS or EOM was the independent influencing factors for omalizumab treatment failure(P<0.05).Conclusion Combination with ECRS or EOM may lead to ineffective treatment of omalizumab in patients with severe asthma.These patients are advised to consider anti-interleukin(IL)-5 antibody or anti-IL-5Rαantibody therapy.