Experience of using dupilumab in the treatment of severe asthma

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The article provides data on modern approaches to the treatment of patients with severe uncontrolled bronchial asthma with an emphasis on the use of dupilumab, a human recombinant monoclonal antibody to the alpha subunit of the interleukin (IL)-4 receptor, which inhibits signal transmission from both IL-4 and IL-13. The results of dupilumab pivotal randomized clinical trials DRI12544, QUEST and VENTURE are summarized. Indications for use of this medicinal product are listed in Federal Clinical Guidelines on the management of asthma (year of revision 2019). Clinical cases with various clinical course of bronchial asthma are described, including cases with frequent exacerbations. In conclusion, dupilumab could be a treatment of choice for the patients with severe bronchial asthma and it is reasonable from an economic, clinical and pathogenetic point of view.

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G. Ignatova

South Ural State Medical University

编辑信件的主要联系方式.
Email: ant-vn@yandex.ru
ORCID iD: 0000-0002-0877-6554

д.м.н., проф., зав. каф. терапии Института ДПО ФГБОУ ВО ЮУГМУ

俄罗斯联邦, Chelyabinsk

V. Antonov

South Ural State Medical University

Email: ant-vn@yandex.ru
ORCID iD: 0000-0002-3531-3491

д.м.н., доц. каф. терапии Института ДПО ФГБОУ ВО ЮУГМУ

俄罗斯联邦, Chelyabinsk

E. Makarova

South Ural State Medical University

Email: ant-vn@yandex.ru
ORCID iD: 0000-0002-6182-069X

аспирант каф. терапии Института ДПО ФГБОУ ВО ЮУГМУ

俄罗斯联邦, Chelyabinsk

S. Kochetkova

Regional Clinical Hospital №3

Email: ant-vn@yandex.ru

зав. пульмонологическим отд-нием №2 ГБУЗ ОКБ №3

俄罗斯联邦, Chelyabinsk

参考

  1. The Global Initiative for Asthma (GINA). https://ginasthma.org/gina-reports/
  2. Клинические рекомендации по бронхиальной астме 2019 [Federal Clinical guidelines for bronchial asthma 2019. (In Russ.)]. http://spulmo.ru/ obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/
  3. Ненашева Н.М. Фенотипы бронхиальной астмы и выбор терапии. Практическая пульмонология. 2014;2:2-11 [Nenasheva N M. Phenotypes of bronchial asthma and the choice of therapy. Practical pulmonology. 2014;2:2-11 (In Russ.)].
  4. Steinke JW, Borish L. Th2 cytokines and asthma Interleukin-4: its role in the pathogenesis of asthma, and targeting it for asthma treatment with interleukin-4 receptor antagonists. Respir Res. 2001;2(2):66-70. doi: 10.1186/rr40
  5. Mahajan S, Mehta AA. Role of cytokines in pathophysiology of asthma. Iran J Pharmacol Therap. 2006;5:1-14.
  6. Busse WW. Biological treatments for severe asthma: A major advance in asthma care. Allergol Int. 2019;68(2):158-66. doi: 10.1016/j.alit.2019.01.004
  7. Rabe KF, 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
  8. Bachert C, et al. Efficacy and Safety of Dupilumab in Patients With Severe Chronic Rhinosinusitis With Nasal Polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): Results From Two Multicentre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Phase 3 Trials. Lancet. 2019;394(10209):1638-50. doi: 10.1016/S0140-6736(19)31881-1
  9. Agache I, et al. Efficacy and Safety of Treatment With Dupilumab for Severe Asthma: A Systematic Review of the EAACI guidelines-Recommendations on the Use of Biologicals in Severe Asthma. Allergy. 2020. doi: 10.1111/all.14268
  10. Саласюк А.C., Фролов М.Ю., Барыкина И.Н. Дупилумаб при тяжелой неконтролируемой бронхиальной астме – экономические аспекты применения. Качественная клиническая практика. 2019;2:15-24. [Salasyuk AC, Frolov MYu, Barykina IN. Dupilumab for severe uncontrolled bronchial asthma-economic aspects of its use. Good clinical practice. 2019;2:15-24 (In Russ.)]. doi: 10.24411/2588-0519-2019-10069
  11. Mitchell PD, El-Gammal AI, O’Byrne PM. Emerging monoclonal antibodies as targeted innovative therapeutic approaches to asthma. Clin Pharmacol Ther. 2016;99(1):38-48. doi: 10.1002/cpt.284

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