对不受控制的CRSwNP进行抗TSLP单克隆抗体:DUBHE随机临床试验
Mu Xian1,2,3, Feng Lan1,2,3, Bing Yan1,2,3
1Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Nature communications
|September 29, 2025
概括
这项研究表明,CM326是一种胸膜 stromal lymphopoietin (TSLP) 抑制剂,在患有带鼻息肉的eosinophilic慢性鼻炎 (ECRSwNP) 的患者中有效降低鼻息肉大小. 较高的TSLP基线水平预测了更好的治疗反应.
科学领域:
- 免疫学 免疫学 免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 临床药理学 临床药理学
背景情况:
- 带鼻息肉的慢性鼻炎 (CRSwNP) 是一种复杂的炎症上呼吸道疾病.
- 胸膜 stromal lymphopoietin (TSLP) 是一种关键的细胞因子,涉及到驱动CRSwNP病变的2型炎症.
- 准TSLP为CRSwNP提供了一个潜在的治疗策略,特别是对eosinophilic表型.
研究的目的:
- 评估CM326的安全性和有效性,一种针对TSLP的单克隆抗体,在不受控制的CRSwNP的患者中.
- 评估CM326对CRSwNP患者鼻息肉大小 (NPS) 和相关生物标志物的影响.
- 为了确定CM326治疗反应的潜在预测标记.
主要方法:
- 一个阶段1b/2a,随机,双盲,安慰剂受控试验,涉及84名患有不受控制的CRSwNP的患者.
- 患者每隔2周或4周接受CM326 (220毫克) 或安慰剂,持续16周,随后延长开放标签治疗期.
- 主要终点包括16周的安全性和NPS的变化,这些都是在埃索诺菲尔CRSwNP (ECRSwNP) 患者身上.
主要成果:
- 每隔2周 (Q2W) 服用CM326的ECRSwNP患者在16周与安慰剂相比,显著改善了NPS (平均差异:-1.2;P=0.04).
- 用CM326 Q2W治疗导致了外周血液和组织中异氨基细胞的数量以及血IL-5和IL-13水平的降低.
- 后期分析表明,在基线TSLP>330 fg/mL的患者中,CM326 Q2W显著减少了NPS (平均差异与安慰剂相比:-1.75;P=0.01).
结论:
- CM326耐受性很好,并且在未经控制的ECRSwNP.NP患者中改善NPS的疗效得到证明.
- 这项研究表明,CM326 Q2W是ECRSwNP的一种有前途的治疗选择.
- 血TSLP基线水平为330 fg/mL,可以作为CM326治疗疗效的预测生物标志物.
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