奥马珠单抗治疗阿司匹林加重性呼吸系统疾病3例并文献复习

Aspirin-exacerbated respiratory disease treated with omalizumab:3 cases report and literature review

目的对使用奥马珠单抗治疗的阿司匹林加重性呼吸系统疾病(AERD)病例进行分析,并回顾相关文献。方法回顾性分析2018年3月1日至2021年12月31日北京大学第一医院使用奥马珠单抗治疗的3例AERD患者的临床资料。在PubMed数据库、中国知网、万方数据库中检索截至2022年1月31日的相关文献,对评价奥马珠单抗治疗AERD疗效的临床研究进行总结。结果我院3例AERD患者经奥马珠单抗治疗32周至68周,上、下呼吸道症状均有改善,肺功能有所提高,外周血嗜酸性粒细胞百分比降低。共检索到使用奥马珠单抗治疗AERD的临床研究14项,其中3项为随机、双盲、安慰剂对照研究,11项为治疗前后自身对照研究。大部分研究显示奥马珠单抗可改善AERD患者症状,减少哮喘急性发作、减少全身糖皮质激素使用。结论奥马珠单抗可改善AERD的疾病控制,但仍需更多循证医学证据。

Objective To summarize the clinical data of aspirin-exacerbated respiratory disease(AERD)treated with omalizumab in Peking University First Hospital and reviewed the relative literatures.Methods We analyzed retrospectively the clinical data of three cases of AERD treated with omalizumab in Peking University First Hospital from March 1,2018 to December 31,2021.The clinical researches on the treatment of AERD with omalizumab up to January 31,2022 were retrieved in PubMed,China National Knowledge Infrastructure(CNKI)and Wanfang Data.Results Our three patients of AERD treated with omalizumab for 32 to 68 weeks obtained relief of symptoms of upper and lower respiratory tract,improvement in lung function,and reduction in percentage of blood eosinophils.There were 14 clinical studies on treatment of AERD with omalizumab,including 3 randomized,double-blind and placebo-controlled studies and 11 self-controlled case series studies.The majority of studies showed that omalizumab contributed to improve the symptoms of AERD,decrease the frequency of asthma attacks and reduce systemic glucocorticoid use.Conclusion Omalizumab can improve the disease control of AERD,but further studies are needed.