Experience of using dupilumab in the treatment of severe bronchial asthma: a clinical case
- Authors: Sergeeva G.R1, Tsukanova I.V2, Demyanova T.V3, Emelyanov A.V.1
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Affiliations:
- North-Western State Medical University n.a. I.I. Mechnikov
- City Outpatient Clinic № 94
- St. Elizabeth Hospital
- Issue: Vol 28, No 10 (2021)
- Pages: 124-128
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/313266
- DOI: https://doi.org/10.18565/pharmateca.2021.10.124-128
- ID: 313266
Cite item
Abstract
Background. Treatment of patients with severe bronchial asthma (BA) using immunobiological drugs requires determination of BA phenotypes and endotypes based on the clinical features of the disease and biological markers. CurrentlY., 5 biological drugs are registered in the Russian Federation for the treatment of patients with the T2 endotype of the disease, which can manifest itself as atopic, eosinophilic, hormone-dependent BA phenotypes, or their combination. The experience of using monoclonal antibodies against interleukin 4/13 (dupilumab) for additional treatment of severe AD in real clinical practice is relatively small. Description of the clinical case. The article presents an experience of 1-year use of dupilumab (600 mg starting dose, then 300 mg every 2 weeks) in a patient with a severe hormone-dependent atopic eosinophilic BA, uncontrolled by high doses of inhaled glucocorticoids in combination with long-acting inhaled ß2-adrenomimetics, anticholinergics, and oral steroids, with initially elevated levels of exhaled nitric oxide and low lung function. Conclusion. During the treatment with dupilumab, there was a significant improvement in the control of the disease and the patient’s quality of life, a decrease in the dose of oral glucocorticoids by more than 2 times, and a significant decrease in the use of health care resources.
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About the authors
G. R Sergeeva
North-Western State Medical University n.a. I.I. MechnikovSt. Petersburg, Russia
I. V Tsukanova
City Outpatient Clinic № 94St. Petersburg, Russia
T. V Demyanova
St. Elizabeth HospitalSt. Petersburg, Russia
Aleksandr V. Emelyanov
North-Western State Medical University n.a. I.I. Mechnikov
Email: emelav@inbox.ru
Dr. Sci. (Med.), Professor, Head of the Department of Pulmonology St. Petersburg, Russia
References
- Chung K.F., Wenzel S.E., Brozek J.L., et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343-47. doi: 10.1183/0903936.00202031.
- Global lnitiative for asthma. NHLB/WHO Workhop Report. National Lung Blood lnstitute, updated 2021. URLhttps://ginasthma.org (Accessed 19.08.2021).
- Bousquet J., Khaltaev N, Cruz A., et al. World Health Organization; GA(2)LEN; AllerGen. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl. 86):8-160. doi: 10.1111/j.1398-9995.2007.01620.x.
- Maio S., Baldacci S., Bresciani M., et al. AGAVE group. RItA: The Italian severe/uncontrolled asthma registry. Allergy. 2018;73(3):683-95. doi: 10.1111/all.13342.
- Сергеева Г.Р., Емельянов А.В., Лешенкова Е.В., Знахуренко А.А. Биомаркеры воспаления дыхательных путей у пациентов с тяжелой бронхиальной астмой в реальной клинической практике. Пульмонология. 2020;30(4):437-45.
- Agache I., Akdis C., Akdis M., et al. EAACI Biologicals Guidelines-Recommendations for severe asthma. Allergy 2021;76(1):14-44. doi: 10.1111/all.14425.
- Бронхиальная астма. Федеральные клинические рекомендации 2019.
- Ray A., Raundhal M., Oriss T.B., et al. Current concepts of severe asthma. J Clin Invest. 2016;126(7):2394-403. Doi: 10.1172/ JCI84144.
- Gandhi N., Bennett B., Graham N., et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35-50. doi: 10.1038/nrd4624.
- Castro M., Corren J., Pavord I.D., et al. Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018;378(26):2486-96. Doi: 10.1056/ NEJMoa1804092.
- Busse W.W, Maspero J.F, Rabe K.F, et al. Liberty Asthma QUEST: Phase 3 Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate Dupilumab Efficacy/Safety in Patients with Uncontrolled, Moderate-to-Severe Asthma. Adv Ther. 2018;35(5):737-48. Doi: 10.1007/ s12325-018-0702-4.
- Rabe K.F, Nair Fl, Brusselle G., et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. N Engl J Med. 2018;378(26):2475-85. Doi: 10.1056/ NEJMoa1804093.
- Инструкция по медицинскому применению лекарственного препарата Дупиксент® РУ № ЛП-005440
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