NOVAS ESTRATÉGIAS NO MANEJO DA ASMA MODERADA E GRAVE REFRATÁRIA
UMA REVISÃO SISTEMÁTICA
Palavras-chave:
Palavras-chave: asma grave; asma refratária; terapias biológicas; controle da asma; exacerbações da asmaResumo
Objetivo: Avaliar os benefícios e a segurança de novas estratégias terapêuticas, especialmente terapias biológicas, no manejo da asma grave refratária em adultos. Métodos: Revisão sistemática de 16 artigos selecionados a partir de 1303 estudos, utilizando termos MeSH relacionados à asma refratária e terapias biológicas. Foram incluídos estudos que abordam o controle da asma, função pulmonar e qualidade de vida. Resultados: Terapias como benralizumabe, dupilumabe, mepolizumabe e tezepelumab demonstraram eficácia significativa na redução de exacerbações, melhora da qualidade de vida e redução no uso de corticosteroides, com segurança comprovada. Discussão: As terapias biológicas mostraram potencial para controlar a asma grave, reduzindo a inflamação e exacerbando menos a doença. No entanto, algumas delas, como o risankizumabe, não se mostraram eficazes, o que evidencia a necessidade de mais estudos. Conclusão: As terapias biológicas são alternativas promissoras no tratamento da asma grave refratária, oferecendo melhores resultados no controle da doença e na qualidade de vida dos pacientes que não respondem ao tratamento convencional.
Referências
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention [Internet]. 2024. Available from: https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
Corren J, Pham TH, Esther Garcia Gil, Kinga Sałapa, Ren P, Parnes JR, et al. Baseline type 2 biomarker levels and response to tezepelumab in severe asthma. Allergy [Internet]. 2022 Jun [cited 2024 Sep 16];77(6):1786–96. Available from: https://onlinelibrary.wiley.com/doi/10.1111/all.15197
Diver. Effect of tezepelumab on airway inflammatory cells, remodelling, and hyperresponsiveness in patients with moderate-to-severe uncontrolled asthma (CASCADE): a double-blind, randomised, placebo-controlled, phase 2 trial. The Lancet Respiratory medicine [Internet]. 2021 [cited 2024 Sep 16];9(11). Available from: https://pubmed.ncbi.nlm.nih.gov/34256031/
Wechsler. Efficacy and Safety of Itepekimab in Patients with Moderate-to-Severe Asthma. The New England journal of medicine [Internet]. 2021 [cited 2024 Sep 16];385(18). Available from: https://pubmed.ncbi.nlm.nih.gov/34706171/
Kelsen. Astegolimab (anti-ST2) efficacy and safety in adults with severe asthma: A randomized clinical trial. The Journal of allergy and clinical immunology [Internet]. 2021 [cited 2024 Sep 16];148(3). Available from: https://pubmed.ncbi.nlm.nih.gov/33872652/
Jackson DJ;Heaney J. Reduction of daily maintenance inhaled corticosteroids in patients with severe eosinophilic asthma treated with benralizumab (SHAMAL): a randomised, multicentre, open-label, phase 4 study. Lancet (London, England) [Internet]. 2024 [cited 2024 Sep 16];403(10423). Available from: https://pubmed.ncbi.nlm.nih.gov/38071986/
McIntosh. Asthma Control, Airway Mucus, and 129Xe MRI Ventilation After a Single Benralizumab Dose. Chest [Internet]. 2022 [cited 2024 Sep 16];162(3). Available from: https://pubmed.ncbi.nlm.nih.gov/35283104/
Brightling CE;Nair P;Cousins DJ;Louis R;Singh D. Risankizumab in Severe Asthma - A Phase 2a, Placebo-Controlled Trial. The New England journal of medicine [Internet]. 2021 [cited 2024 Sep 16];385(18). Available from: https://pubmed.ncbi.nlm.nih.gov/34706172/
Schleich. Real-word experience with mepolizumab: Does it deliver what it has promised? Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology [Internet]. 2020 [cited 2024 Sep 16];50(6). Available from: https://pubmed.ncbi.nlm.nih.gov/32198794/
Pertzov B;Unterman A;Shtraichman O;Shitenberg D;Rosengarten D;Kramer MR. Efficacy and safety of mepolizumab in a real-world cohort of patients with severe eosinophilic asthma. The Journal of asthma : official journal of the Association for the Care of Asthma [Internet]. 2021 [cited 2024 Sep 16];58(1). Available from: https://pubmed.ncbi.nlm.nih.gov/31479312/
Kallieri M;Zervas E;Katsoulis K;Fouka E;Porpodis K;Samitas K;Papaioannou AI;Kipourou M;Gaki E;Vittorakis S;Markatos M;Dimakou K;Ampelioti S;Koukidou S;Makris M;Ntakoula M;Mitrova MH;Glynos K;Antoniou KM;Gaga M;Tzanakis N;Markopoulou K;Papakosta D;Bakakos P;Loukides S. Mepolizumab in Severe Eosinophilic Asthma: A 2-Year Follow-Up in Specialized Asthma Clinics in Greece: An Interim Analysis. International archives of allergy and immunology [Internet]. 2020 [cited 2024 Sep 16];181(8). Available from: https://pubmed.ncbi.nlm.nih.gov/32570256/
Dupin. Effectiveness and safety of dupilumab for the treatment of severe asthma in a real-life French multi-centre adult cohort. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology [Internet]. 2020 [cited 2024 Sep 16];50(7). Available from: https://pubmed.ncbi.nlm.nih.gov/32469092/
Moss. Results of a Phase 2b Trial With GB001, a Prostaglandin D2 Receptor 2 Antagonist, in Moderate to Severe Eosinophilic Asthma. Chest [Internet]. 2022 [cited 2024 Sep 16];162(2). Available from: https://pubmed.ncbi.nlm.nih.gov/35248549/
Ibrahim. The effectiveness of Reslizumab in severe asthma treatment: a real-world experience. Respiratory research [Internet]. 2019 [cited 2024 Sep 16];20(1). Available from: https://pubmed.ncbi.nlm.nih.gov/31861993/
Pérez de Llano, Luis A et al. “Efficacy and Safety of Reslizumab in Patients with Severe Asthma with Inadequate Response to Omalizumab: A Multicenter, Open-Label Pilot Study.” The journal of allergy and clinical immunology. In practice vol. 7,7 (2019): 2277-2283.e2. doi:10.1016/j.jaip.2019.01.017.
Pelaia C;Crimi C;Pelaia G;Nolasco S;Campisi R;Heffler E;Valenti G;Crimi N. Real-life evaluation of mepolizumab efficacy in patients with severe eosinophilic asthma, according to atopic trait and allergic phenotype. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology [Internet]. 2020 [cited 2024 Sep 16];50(7). Available from: https://pubmed.ncbi.nlm.nih.gov/32347992/
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Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
