在患有严重喘的儿童中选择生物治疗
Latika Gupta1, Michele Arigliani2, James Cook3
1Department of Paediatric Respiratory Medicine, King's College Hospital NHS Foundation Trust, London, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Paediatric respiratory reviews
|July 9, 2025
概括
对儿童严重喘的新生物疗法提供了多种不同的治疗选择. 本综述总结了第三阶段试验的结果,并提出了根据炎症内型选择合适的生物制剂的算法.
科学领域:
- 儿科肺病学 儿科肺病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 针对IgE的奥马利祖马布是2003年治疗严重喘的第一个生物药物.
- 现在有几种针对特定炎症途径 (IL-5,IL-4/IL-13,TSLP) 的新生物药物用于儿科严重喘.
- 不断扩大的生物组合在识别患者内型和反应标准方面提出了挑战.
研究的目的:
- 总结了儿童严重喘中的生物药物3期试验结果.
- 讨论在儿童和青少年中个性化生物治疗的实际考虑.
- 提出一个算法,在这个人群中启动生物治疗.
主要方法:
- 对已批准的生物制剂的第三阶段临床试验数据的审查.
- 对生物选择的临床实践考虑的讨论.
- 基于喘内型的提议启动算法的开发.
主要成果:
- 针对不同途径 (抗IgE,抗IL-5,抗IL-5R,抗IL-4/13R,抗TSLP) 的生物药物已在儿童严重喘中表现出有效性.
- 准确的内型和表型对于最佳的生物选择至关重要.
- 第三阶段试验提供了治疗反应和安全性概况的证据.
结论:
- 越来越多的生物药物需要根据特定的炎症概况进行仔细的患者选择.
- 算法方法可以指导临床医生为患有严重喘的儿童和青少年启动适当的生物疗法.
- 个性化医疗策略对于最大限度地提高儿童严重喘治疗效益至关重要.
相关概念视频
01:20Asthma: Pathogenesis and Management
607
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
607
01:30Asthma-IV: Diagnostic and Management
2.6K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.6K
01:26Asthma-II: Pathophysiology and Classification
2.9K
Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
2.9K
01:19Antiasthma Drugs: Leukotriene Modifiers
489
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
489
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
398
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
398
01:30Asthma-IV: Nursing Management
3.3K
The nursing management of asthma is a comprehensive approach that relies heavily on the expertise and dedication of healthcare professionals. It involves thorough assessment, accurate diagnosis, strategic planning, effective implementation, and diligent evaluation. By meticulously following this step-by-step process, healthcare professionals play a crucial role in providing the best possible care and treatment for patients with asthma, enhancing their overall health and well-being.
First, in...
First, in...
3.3K