Severe bronchial asthma. Current diagnostic and treatment options


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Abstract

The article contains a review of literature data on diagnostic criteria and modern approaches to the treatment of severe bronchial asthma (SBA), which has high medical and social importance. To confirm the diagnosis, an assessment of the allergological status, the determination of biological markers of the disease is necessary. The modern possibilities of treatment with monoclonal antibodies of this form of the disease, as well as the most studied options for future treatment of SBA are discussed.

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About the authors

Roman E. Leshchenko

Medical Association “New Hospital"

Email: leshchenkoiv@yandex.ru
anesthesiologist-critical care physician

T. Z Buladzhova

Medical Association “New Hospital"

References

  1. Бронхиальная астма. Клинические рекомендации, 2018. URL: www.spulmo.ru [Bronchial asthma. Clinical guidelines, 2018. (In Russ.)].
  2. Global strategy for asthma management and prevention, 2018. Available at: http://www. ginasthma.org/uploads/users/files/GINA [Accessed June 26, 2018].
  3. Bousqet J., Mantzouranis E., Cruz A.A., et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010;126:926 38. doi: 10.1016/j.jaci.2010.07.019
  4. Ненашева Н.М. Биологическая терапия бронхиальной астмы: настоявшее и будущее. Consilium Medicum. 2016;18:30-8
  5. Hancox R.L. Cowan D.C., Aldridge R.E., et al. Asthma phenotypes: consistency of classification using induced sputum. Respirology. 2012;17(3):461-66. doi: 10.1111/j.1440-1843.2011.02113.x.
  6. Wenzel S. Asthma phenotypes: the evolution from clinical to molecular approaches. Nature Medicine. 2012;18(5):716-25. doi: 10.1038/nm.2678.
  7. Murano A., Lemanske R.F., Hellings P.W., et al. Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology J. Allergy Clin Immunol. 2016;137(5):1347-58. doi: 10.1016/j.jaci.2016.03.010.
  8. Fahy J. Eosinophilic and neutrophilic inflammation in asthma: insights from clinical studies. Proc Am Thorac Soc. 2009;6:256-59. Doi: 10.1513/ pats.200808-087RM.
  9. Louis R., Lau L., Bron A.O., et al. The relationship between airways inflammation and asthma severity. Am J. Respir Crit Care Med. 2000; 161:9-16.
  10. Wardlaw A.J., Brightling C., Green R., et al. Eosinophils in asthma and other allergic. Br Med Bulletin. 2000;256(4):985-1003.
  11. van Veen I.H., ten Brinke A., Gauw S.A., et al. Consistency of sputum eosinophilia in difficult-to-treat asthma: a 5-year follow-up study J. Allergy Clin Immunol. 2009;124:615-17. Doi: 10.1016.0.2009.06029.
  12. Ulrik C. Peripheral eosinophil counts as a marker of disease activity in intrinsic and extrinsic asthma. Clin Exp Allergy. 1995;25:820-27.
  13. Ali Z., Dirks C.G., Ulrik C.S. Long-term Mortality Among Adults with Asthma: a 25-yaer follow-up of 1,075 outpatients with asthma. Chest. 2013;143:1649-55. Doi: 10.1378/ chest.12-2289.
  14. Zieger R.S., Schatz M., Li Q., et al. High blood eosinophil count is a risk factor for future asthma exacerbations in adult persistent asthma. J. Allergy Clin Immunol Pract. 2014;2(6):741-50. Doi: 10.101-/j.jaip.2014.0-.005.
  15. Buhl R., Humbert M., Bjermer L., et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J. 2017;49:1700634. doi: 10.1183/13993003.00634-2017.
  16. Цыпленкова С.Э., Мизерницкий Ю.Л. Уровень оксида азота в выдыхаемом воздухе как биологический маркер аллергического воспаления дыхательных путей у детей. Пульмонология. 2007;4:69-78.
  17. Харитонов С.А., Барнс П.Дж., Чучалин А.Г. Окись азота (NO) в выдыхаемом воздухе: новый тест в пульмонологии. Пульмонология. 1997;7:7- 13.
  18. Jarvis M.J., Russell M.A., Saloojee Y Expired air carbon monoxide: a simple breath test of tobacco smoke intake. Br. Med. J. 1980;281(6238): 484-85
  19. Jia G., Erickson R.W., Choy D., et al. Periostin is a systemic biomarker of eosinophilic airway inflammation in asthmatic patients. J Allergy Clin Immunol. 2012;130:647-54. Doi: 10.1016/j. jaci.2012.06.025
  20. Scheerens H., Arron J.R., Su Z., et al. Predictive and pharmacodynamic biomarkers of interleukin-13 blockade: effect of lebrikizumab on late phase asthmatic response to allergen challenge. J. Allergy Clin Immunol. 2011;127(2):AB1-.
  21. Hanania N.A., Noonan M.J., Corren J., et al. Efficacy and safety of lebrikizumab in severe uncontrolled asthma: results from the lute and verse phase II randomized, double-blind, placebo-controlled trials. J. Allergy Clin Immunol. 2014;133(2):AB402.
  22. Brightling C.E., Chanez P., Leigh R., et al. Efficacy and safety of tralokinumab in patients with severe uncontrolled asthma: a randomised, doubleblind, placebo-controlled, phase 2b trial. Lancet. 2015;3(9):692-701. doi: 10.1016/s2213-2600(15)00197-6.
  23. Kharitonov S.A, Barnes P.J. Exhaled markers of pulmonary disease. Am J Resp Crit Care Med. 2001;163(7):1693-722.
  24. Zhang J., Yao X., Yu R., et al. Exhaled carbon monoxide in asthmatics: a meta-analysis. Respir Res. 2010;11(1):50. doi: 10.1186/1465-9921-11-50.
  25. Yamara M., Sekizawa K., Ishizuka M., et al. Exhaled carbon monoxide levels during treatment of acute asthma. Eur Respr J. 1999;13:757--0
  26. Ильина Н.И., Ненашева Н.М., Авдеев С.Н. и др. Алгоритм биофенотипирования и выбор таргетной терапии тяжелой неконтролируемой бронхиальной астмы с эозинофильным типом воспаления дыхательных путей. Российский аллергологический журнал. 2017;3:5-18
  27. Thomson N.C., Chaudhuri R. Omalizumab: Clinical Use for the Management of Asthma. Clinical Medicine Insights: Circulatory, Respir Pulm Med. 2012:CCR PM. S7793. Do i: 10.413 7/ccrpm. s7793.
  28. Ortega H.G., Yancey S.W., Mayer B., et al. Severe eosinophilic asthma treated with mepolizumab stratified by baseline eosinophil thresholds: a secondary analysis of the DREAM and MENSA studies. Lancet. Respir Med. 2016;4(7): 549-56. doi: 10.1016/S2213-2600(16) 30031-5.
  29. Bachert C., Sousa A.R., Lund V.J., et al. Reduced need for surgery in severe nasal polyposis with mepolizumab: Randomized trial. J. Allerg. Clin Immunol. 2017;140(4):1024-31. doi: 10.1016/j.jaci.2017.05.044
  30. Cockle S.M., Stynes G., Gunsoy N.B., et al. Comparative effectiveness of mepolizumab and omalizumab in severe asthma: An indirect treatment comparison. Respir Med. 2017;123:140-48. doi: 10.1016/j.rmed.2016.12.009.
  31. Castro M., Zangrilli J., Wechsler M.E., et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet. Respir Med. 2015;3:355-66. doi: 10.1016/S2213-2600(15)00042-9.
  32. Mukherjee M., Paramo F., Kjarsgaard M., et al. Weight-adjusted Intravenous Reslizumab in Severe Asthma with Inadequate Response to Fixed-Dose Subcutaneous Mepolizumab. Am J. Respir Crit Care Med. 2018;197(1):38-46. Doi:10.1164/ rccm.201707-1323oc.
  33. FitzGerald J.M., Bleecker E.R., Nair P., et al. Benralizumab an anti-interleukin-5 receptor monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, doubleblind, placebo-controlled phase 3 trial. Lancet. 2016;29:2128-41. doi: 10.1016/S0140-6736(16)31322-8.
  34. Hanania N.A., Korenblat P., Chapman K.R., et al. Efficacy and safety of lebrikizumab in patients with uncontrolled asthma (IAVOLTA I. and IAVOLTA II): replicate, phase 3, randomised, double-blind, placebo-controlled trials. Lancet. Respir Med. 2016;4(10):781-96. doi: 10.1016/S2213-2600(16)30265-X.
  35. Wenzel S., Ford L., Pearlman D., et al. Dupilumab in Persistent Asthma with Elevated Eosinophil levels. N. Engl J. Med. 2013;368(26):2455-66. doi: 10.1056/NEJMoa1304048.
  36. Vatrella A., Fabozzi I., Calabrese C., et al. Dupilumab: a novel treatment for asthma. J. Asthma Aller. 2014;7:123-30. Doi: 10.2147/ JAA.S52387.

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