医学
杜皮鲁玛
奥马佐单抗
哮喘
鼻息肉
重症监护医学
支气管高反应性
过敏性哮喘
内科学
儿科
免疫学
免疫球蛋白E
呼吸道疾病
抗体
肺
作者
Josje Otten,Rik Johannes Leonardus van der Lans,Eugenio De Corso,Kanstantsin Dziadziulia,Bart Hilvering,Els J.M. Weersink,Matteo Bonini,Jan Hagemann,Wanrawee Thaitrakool,Claudio Montuori,Ludger Klimek,Sietze Reitsma,Wytske J. Fokkens
标识
DOI:10.1080/1744666x.2023.2218617
摘要
Type 2 targeting biologics have reached the market first for asthma and since 2019 also for CRSwNP. As clear guidelines and predictors for optimal biological choice are missing, patients are sometimes required to switch biologic therapy in order to find the optimal treatment result. In this paper, we evaluate reasons for switching biologics and the treatment effects after each sequential switch.Ninety-four patients who switched from one biologic to another for their treatment of CRSwNP and asthma were evaluated.Twenty patients experienced satisfactory control of CRSwNP, but insufficient control of severe asthma. Fifty-one patients experienced satisfactory control of severe asthma, but insufficient control of CRSwNP/EOM. Twenty-eight patients experienced insufficient control of both upper and lower airways. Thirteen patients had to switch because of side effects. Furthermore, two cases are described to clarify clinical decision-making.For abovementioned patients, a multidisciplinary approach is mandatory to find the best suitable biologic. It seems ineffective to switch to a second anti-IL5 treatment if the first one is not successful. Most patients that failed omalizumab and/or an anti-IL-5 treatment are well controlled on dupilumab. Therefore, we suggest to use dupilumab as first choice when switching biologic agents.
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