Update in Asthma 2014

Carr, Tara F.; Kraft, Monica

doi:10.1164/rccm.201503-0597up

Cited by 20 publications

(17 citation statements)

References 64 publications

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“…However, despite these studies, the treatment options for asthma remain limited, and steroids are the predominant type of medication [25]. The discovery of different inflammatory phenotypes in patients with BA and the related molecular phenotyping, thanks to new technologies in the field of molecular biology and immunogenetics, have made it possible to synthesize specific monoclonal antibodies, including anti-cytokine antibodies [26].…”

Section: Anti-cytokine Therapymentioning

confidence: 99%

Untitled

2017

JLPRR

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Submit Manuscript | http://medcraveonline.com HT and IHD (comparison group) and 20 were healthy subjects. All patients signed informed consent before the study. The Protocol of the study was passed review and was approved by the local ethics Committee of our University. The presence of IgE was determined to tick and house dust allergens, as well as the combined allergens of grass pollen, trees, weeds and flowers, S. pneumon, H. influenzae, and N. rerflava. The following cytokines were investigated: IL-4, IL-6, IL-10, IL-17, IFNγ, TNFα. All patients were examined during disease exacerbation. The INFP and ATP were determined for each subject. The results of the study of CK levels and CK combinations, the so-called cytokine profile, indicate that they cannot be used for clinical diagnosis, including nosological diagnosis, the assessment of disease severity, and for selecting individual therapy, including anti-cytokine medications.The incredible heterogeneity of bronchial asthma (BA) is becoming more and more clear. More than 30 years ago, in 1977, we pointed out the existence of seven clinical and pathogenetic types of BA in patients, subsequently called the following phenotypes: infection-dependent, atopic, hormonal, neuropsychological, autoimmune, significant adrenergic imbalance, and primary bronchial hyperreactivity [1]. Individual methods of diagnosis and treatment were developed for each of these options, and the results of their testing have been repeatedly published. Subsequently, the phrase "primary bronchial hyperreactivity" was replaced with the idea of exercise-induced BA, peri-menstrual and aspirin-related clinical and pathogenetic types (phenotypes) of BA. The methods of individual diagnosis and treatment continued to improve and their efficacy continued to increase.Inhalation corticosteroids (ICS) are considered to be the most effective in the treatment of BA. However, in 5-10% of patients with BA, comprehensive treatment is ineffective even with the inclusion of ICS [2]. Although the percentage of patients resistant to ICS, is quite low, they make up 50% of the overall cost of treatment for patients with BA [3]. The insufficient treatment efficacy of existing methods for a group of patients with BA is a reason for examining the BA phenotypes and the endotypes that form them. Knowledge of the mechanisms (endotypes) that form the phenotypes creates the prospects for developing new treatment methods, which take into account the individual characteristics of BA in a particular patient. A cluster analysis of two large European cohorts identified two phenotypes. The first refers to patients with early onset allergic BA, while the second comprises mainly women with late onset disease, without atopy, and with a high body mass index [4].Seven parameters were selected to classify the endotypes in patients with BA after the cluster analysis: clinical characteristics, biomarkers, lung physiology, genetics, histopathology, epidemiology, and response to treatment. The following BA endotypes were proposed based o...

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Section: Anti-cytokine Therapymentioning

confidence: 99%

Untitled

2017

JLPRR

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“…Thus, there remains an unmet medical need for additional treatment options metrological for these patients with uncontrolled asthma [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

“…Several drugs are now available for patients with uncontrolled severe asthma even after treatment with high doses of ICS and two or more controller therapies 1 . Recent phase 3 trials of anti-interleukin IL -5 therapy showed signi cant reductions in the number / severity of exacerbations in patients with asthma that is refractory to current conventional therapies 4 5 10 11 .…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Adverse Effect Profiles of Two Anti-IL-5 Therapies in Adults with Uncontrolled Asthma

Koichi:筆頭著者:責任著者

Miyata

Hirai

et al. 2017

Showa Univ J Med Sci

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: The aim of this study was to compare the adverse effect profiles of mepolizumab MPZ and benralizumab BRZ in adults with uncontrolled asthma. A network meta-analysis of phase 3 trials was conducted to compare the adverse effects of MPZ and BRZ in patients with uncontrolled asthma. The MEDLINEPubMed, Scopus and the Cochrane library databases were searched to identify any relevant articles. The outcome measures of fatal adverse events, headache, and injection site reaction are presented as odds ratios ORs with 95 confidence intervals CIs . The surface under the cumulative curve SUCRA for each outcome was also compared among MPZ, BRZ, and placebo treatments. Four randomized controlled trials of MPZ 100 mg s/c every four weeks 100-MPZ or BRZ 30 mg s/c every eight weeks 30-BRZ met the criteria for inclusion in the study. The ORs and 95 CIs of 100-MPZ compared with BRZ for fatal adverse events, headache, and injection site reaction were 0.26 0.01-4.90 , 0.79 0.40-1.54 , and 2.32 0.79-6.80 , respectively. SUCRAs for 100-MPZ, 30-BRZ, and placebo were 0.8, 0.3, and 0.4 for fatal adverse events, 0.5, 0.1, and 0.8 for headache, and 0.0, 0.6, and 0.8 for injection site reaction, respectively. There were no signi cant differences in the incidence of fatal adverse events, headache, and injection site reaction between MPZ and BRZ treatment. However, the SUCRA values indicate an association between administration of BRZ and the occurrence of fatal adverse event or headache, or between administration of MPZ and the occurrence of injection site reaction. Moreover, the incidence odds of injection site reaction were signi cantly higher in the MPZ group than in the placebo group. Further analysis will be needed to clarify the details of safety pro les of these anti-IL-5 therapies.

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“…However, there are still many patients with asthma that is not optimally controlled by a combination of drugs, including ICS and systemic glucocorticoids 3 . Therefore, there is an unmet medical need for additional treatment options for these patients [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

“…Several drugs are available for the treatment of patients with severe eosinophilic asthma that is uncontrolled by high doses of ICS or two or more controller therapies 1 . Recent trials of anti-interleukin IL -5 agents in patients with severe asthma refractory to existing therapies and prominent sputum eosinophilia showed significant reductions in exacerbations 4 5 .…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of Low-versus High-dose Benralizumab in Adults with Uncontrolled Eosinophilic Asthma

Koichi:筆頭著者:責任著者

Tanaka

Yokoe

et al. 2016

Showa Univ J Med Sci

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: The aim of the present study was to assess the non-inferiority of lowdose benralizumab relative to high-dose benralizumab as a treatment option for uncontrolled eosinophilic asthma through a meta-analysis of ef cacy and safety in randomized controlled trials RCTs . PubMed, the Cochrane Library Database, and Scopus were searched to identify relevant articles. Outcome measures were a change in the Asthma Control Questionnaire-6 ACQ-6 score and the exacerbation rate. In addition, the meta-analysis assessed the incidence of adverse events, injection site reactions, and pyrexia or influenza-like illness. Two RCTs with two doses of benralizumab 20 and 100 mg and a placebo for the treatment of uncontrolled eosinophilic asthma met the criteria and were included in the present study. Non-inferiority of low-dose 20 mg versus high-dose 100 mg benralizumab was shown for the change in ACQ-6 score, exacerbation rate, and the incidence of adverse events, injection site reactions, and pyrexia or influenza-like illness. Although not signi cant, the incidence of pyrexia or in uenza-like illness was lower in patients treated with low-dose benralizumab. These results suggest that low-dose 20 mg benralizumab is effective for symptom control and reduction of exacerbation rate in uncontrolled eosinophilic asthma, with lower treatment costs.

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Update in Asthma 2014

Cited by 20 publications

References 64 publications

Untitled

Untitled

A Comparison of Adverse Effect Profiles of Two Anti-IL-5 Therapies in Adults with Uncontrolled Asthma

Meta-analysis of Low-versus High-dose Benralizumab in Adults with Uncontrolled Eosinophilic Asthma

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