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Тяжелая бронхиальная астма: особенности течения и фенотипы
Тяжелая бронхиальная астма: особенности течения и фенотипы
Ненашева Н.М. Тяжелая бронхиальная астма: особенности течения и фенотипы. Болезни органов дыхания (Прил. к журн. Consilium Medicum). 2018; c. 7–14. DOI: 10.26442/2619-0079.2018.7-14
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Аннотация
За последнее время произошли существенные изменения в подходах к лечению тяжелой бронхиальной астмы. Пациенты, страдающие тяжелой астмой, как правило, рефрактерны к традиционной терапии, у них отмечается высокая частота обострений, незапланированных визитов к врачу и обращений за неотложной медицинской помощью, госпитализаций. Тяжелая бронхиальная астма, как вся астма, не однородна: выделяют разные фенотипы и эндотипы заболевания. В статье обсуждаются вопросы определения тяжелой астмы, диагностики и дифференциальной диагностики, а также фенотипы и эндотипы заболевания. Определение фенотипа тяжелой астмы имеет решающее значение для выбора биологической терапии заболевания. Три биологических препарата (омализумаб, меполизумаб и реслизумаб) уже одобрены для применения в обычной клинической практике в ряде стран, в том числе в России.
Ключевые слова: тяжелая астма, фенотипы тяжелой астмы, тяжелая эозинофильная астма, биологическая терапия, омализумаб, меполизумаб, реслизумаб.
Key words: severe asthma, phenotypes of severe asthma, severe eosinophilic asthma, biological therapy, omalizumab, mepolizumab, reslizumab.
Ключевые слова: тяжелая астма, фенотипы тяжелой астмы, тяжелая эозинофильная астма, биологическая терапия, омализумаб, меполизумаб, реслизумаб.
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Key words: severe asthma, phenotypes of severe asthma, severe eosinophilic asthma, biological therapy, omalizumab, mepolizumab, reslizumab.
Полный текст
Список литературы
1. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma
(GINA) 2018. Available from: http://www.ginasthma.org/
2. Bousqet J, Mantzouranis E, Cruz AA et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol 2010; 126: 926–38.
3. Chung KF, Wenzel S, Brozek J et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43: 343–73.
4. Porsbjerg C, Menzies-Gow A. Co-morbidities in severe asthma: Clinical impact and management. Respirology 2017; 22 (4): 651–61.
5. Hekking PP, Wener RR, Amelink M et al. The prevalence of severe refractory asthma.
J Allergy Clin Immunol 2015; 135 (4): 896–902.
6. Wenzel SE, Vitari CA, Shende M et al. Asthmatic granulomatosis: a novel disease with asthmatic and granulomatous features. Am J Respire Crit Care Med 2012; 186 (Issue 5): 501–7. DOI: 10.1164/rccm.201203-0476OC
7. Ненашева Н.М., Белевский А.С., Фассахов Р.С., Емельянов А.В. Фенотипы трудной для терапии бронхиальной астмы: возможности достижения контроля. РАЖ. 2016; 4–5: 43–54. / Nenasheva N.M., Belevskii A.S., Fassakhov R.S., Emel'ianov A.V. Fenotipy trudnoĭ dlia terapii bronkhial'noi astmy: vozmozhnosti dostizheniia kontrolia. RAZh. 2016; 4–5: 43–54. [in Russian]
8. Luskin AT, Chipps BE, Rasouliyan L et al. Impact of asthma exacerbations and asthma triggers on asthma-related quality of life in patients with severe or difficult-to-treat asthma. J Allergy Clin Immunol Pract 2014; 2 (5): 544–52. DOI: 10.1016/j.jaip.2014.02.011
9. Moore WC, Bleecker ER, Curran-Everett D et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol 2007; 119: 405–13.
10. Haldar P, Pavord I, Shaw D et al. Cluster analysis and clinical asthma phenotypes.
Am J Respir Crit Care Med 2008; 178: 218–24.
11. Moore WC, Meyers DA, Wenzel SE et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010; 181: 315–23.
12. Wenzel S. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18: 716–25.
13. Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med 2013; 19 (8): 977.
14. Сергеева Г.Р., Емельянов А.В., Коровина О.В. и др. Тяжелая бронхиальная астма: характеристика пациентов в клинической практике. Терапевтический архив. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 / Sergeeva G.R., Emel'ianov A.V., Korovina O.V. i dr. Tiazhelaia bronkhial'naia astma: kharakteristika patsientov v klinicheskoi praktike. Therapeutic archive. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 [in Russian]
15. Schleich F, Brusselle G, Louis R et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med 2014; 108: 1723–32.
16. Shau DE, Sousa AR, Fowler SJ et al. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort. Eur Respir J 2015; 46 (5): 1308–21. DOI: 10.1183/13993003.00779-201
17. Kupczyk M, ten Brinke A, Sterk PJ et al. Frequent exacerbators – a distinct phenotype of severe asthma. Clin Exp Allergy 2013; 44: 212–21.
18. Price D, Wilson AM, Chisholm A et al. Predicting frequent asthma exacerbations using blood eosinophil count and other patient data routinely available in clinical practice.
J Asthma Allergy 2016; 9: 1–12. DOI: 10.2147/JAA.S97973
19. Buhl R, Humbert M, Bjermer L et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J 2017; 49. 1700634. DOI: 10.1183/13993003.00634-2017
20. Chung KF, Bel EH, Wenzel SE. Difficult-to-Treat Severe Asthma. European Respiratory Society Monograph 2011; 51.
21. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma. Eur Respir J 2003; 22 (3): 470–7.
22. Desai D, Newby C, Symon FA et al. Elevated sputum interleukin-5 and submucosal eosinophilia in obese individuals with severe asthma. Am J Respir Crit Care Med 2013; 188 (6): 657–63. DOI: 10.1164/rccm.201208-1470OC
23. Moore WC, Hastie AT, Li X et al. National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol 2014; 133 (6): 1557–63.e5. DOI: 10.1016/j.jaci.2013.10.011
24. Denning DW, O’Driscoll BR, Hogaboam CM et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J 2006; 27: 615–26.
25. Denning DW, Pashley C, Hartl D et al. Fungal allergy in asthma-state of the art and research needs. Clin Transl Allergy 2014; 4: 14.
26. Goh KJ, Yil ACA, Lapperre TS et al. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma. J Asthma Allergy 2017; 10: 131–40. DOI: 10.2147/JAA.S130459
27. Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2003; 3: CD001108.
28. Moss RB. Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis. Eur Respir J 2014; 43 (5): 1487–500. DOI: 10.1183/09031936.00139513
29. Ray A, Raundhal M, Oriss T et al. Current concepts of severe asthma. J Clin Invest 2016; 126 (7): 2394–403. DOI: 10.1172/JCI84144
30. Normansell R, Walker S, Milan S et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 20141: CD003559.
31. Rodrigo GJ, Neffen H, Castro-Rodriguez JA. Efficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: a systematic review. Chest 2011; 139 (1): 28–35.
32. Lai T, Wang S, Xu Z et al. Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis. Sci Rep 2015; 5: 8191.
33. Alhossan A, Lee CS, MacDonald K, Abraham I. "Real-life" Effectiveness Studies of Omalizumab in Adult Patients with Severe Allergic Asthma: Meta-analysis. J Allergy Clin Immunol Pract 2017; 5 (5): 1362–70.e2. DOI: 10.1016/j.jaip.2017.02.002.
34. Pavord ID, Korn S, Howarth P et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 2012; 380: 651–9.
35. Ortega HG, Liu MC, Pavord ID et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med 2014; 371: 1198–207.
36. Bel EH, Wenzel SE, Thompson PJ et al. Oral glucocorticoid-sparing effect of mepoli- zumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–97.
37. Castro M, Zangrilli J, Wechlser ME et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicenter, parallel, double-blind, randomized, placebo-controlled, phase 3 trials. Lancet Respir Med 2015; 3: 355–66.
(GINA) 2018. Available from: http://www.ginasthma.org/
2. Bousqet J, Mantzouranis E, Cruz AA et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol 2010; 126: 926–38.
3. Chung KF, Wenzel S, Brozek J et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43: 343–73.
4. Porsbjerg C, Menzies-Gow A. Co-morbidities in severe asthma: Clinical impact and management. Respirology 2017; 22 (4): 651–61.
5. Hekking PP, Wener RR, Amelink M et al. The prevalence of severe refractory asthma.
J Allergy Clin Immunol 2015; 135 (4): 896–902.
6. Wenzel SE, Vitari CA, Shende M et al. Asthmatic granulomatosis: a novel disease with asthmatic and granulomatous features. Am J Respire Crit Care Med 2012; 186 (Issue 5): 501–7. DOI: 10.1164/rccm.201203-0476OC
7. Nenasheva N.M., Belevskii A.S., Fassakhov R.S., Emel'ianov A.V. Fenotipy trudnoĭ dlia terapii bronkhial'noi astmy: vozmozhnosti dostizheniia kontrolia. RAZh. 2016; 4–5: 43–54. [in Russian]
8. Luskin AT, Chipps BE, Rasouliyan L et al. Impact of asthma exacerbations and asthma triggers on asthma-related quality of life in patients with severe or difficult-to-treat asthma. J Allergy Clin Immunol Pract 2014; 2 (5): 544–52. DOI: 10.1016/j.jaip.2014.02.011
9. Moore WC, Bleecker ER, Curran-Everett D et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol 2007; 119: 405–13.
10. Haldar P, Pavord I, Shaw D et al. Cluster analysis and clinical asthma phenotypes.
Am J Respir Crit Care Med 2008; 178: 218–24.
11. Moore WC, Meyers DA, Wenzel SE et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010; 181: 315–23.
12. Wenzel S. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18: 716–25.
13. Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med 2013; 19 (8): 977.
14. Сергеева Г.Р., Емельянов А.В., Коровина О.В. и др. Тяжелая бронхиальная астма: характеристика пациентов в клинической практике. Терапевтический архив. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 / Sergeeva G.R., Emel'ianov A.V., Korovina O.V. i dr. Tiazhelaia bronkhial'naia astma: kharakteristika patsientov v klinicheskoi praktike. Therapeutic archive. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 [in Russian]
15. Schleich F, Brusselle G, Louis R et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med 2014; 108: 1723–32.
16. Shau DE, Sousa AR, Fowler SJ et al. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort. Eur Respir J 2015; 46 (5): 1308–21. DOI: 10.1183/13993003.00779-201
17. Kupczyk M, ten Brinke A, Sterk PJ et al. Frequent exacerbators – a distinct phenotype of severe asthma. Clin Exp Allergy 2013; 44: 212–21.
18. Price D, Wilson AM, Chisholm A et al. Predicting frequent asthma exacerbations using blood eosinophil count and other patient data routinely available in clinical practice.
J Asthma Allergy 2016; 9: 1–12. DOI: 10.2147/JAA.S97973
19. Buhl R, Humbert M, Bjermer L et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J 2017; 49. 1700634. DOI: 10.1183/13993003.00634-2017
20. Chung KF, Bel EH, Wenzel SE. Difficult-to-Treat Severe Asthma. European Respiratory Society Monograph 2011; 51.
21. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma. Eur Respir J 2003; 22 (3): 470–7.
22. Desai D, Newby C, Symon FA et al. Elevated sputum interleukin-5 and submucosal eosinophilia in obese individuals with severe asthma. Am J Respir Crit Care Med 2013; 188 (6): 657–63. DOI: 10.1164/rccm.201208-1470OC
23. Moore WC, Hastie AT, Li X et al. National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol 2014; 133 (6): 1557–63.e5. DOI: 10.1016/j.jaci.2013.10.011
24. Denning DW, O’Driscoll BR, Hogaboam CM et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J 2006; 27: 615–26.
25. Denning DW, Pashley C, Hartl D et al. Fungal allergy in asthma-state of the art and research needs. Clin Transl Allergy 2014; 4: 14.
26. Goh KJ, Yil ACA, Lapperre TS et al. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma. J Asthma Allergy 2017; 10: 131–40. DOI: 10.2147/JAA.S130459
27. Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2003; 3: CD001108.
28. Moss RB. Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis. Eur Respir J 2014; 43 (5): 1487–500. DOI: 10.1183/09031936.00139513
29. Ray A, Raundhal M, Oriss T et al. Current concepts of severe asthma. J Clin Invest 2016; 126 (7): 2394–403. DOI: 10.1172/JCI84144
30. Normansell R, Walker S, Milan S et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 20141: CD003559.
31. Rodrigo GJ, Neffen H, Castro-Rodriguez JA. Efficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: a systematic review. Chest 2011; 139 (1): 28–35.
32. Lai T, Wang S, Xu Z et al. Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis. Sci Rep 2015; 5: 8191.
33. Alhossan A, Lee CS, MacDonald K, Abraham I. "Real-life" Effectiveness Studies of Omalizumab in Adult Patients with Severe Allergic Asthma: Meta-analysis. J Allergy Clin Immunol Pract 2017; 5 (5): 1362–70.e2. DOI: 10.1016/j.jaip.2017.02.002.
34. Pavord ID, Korn S, Howarth P et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 2012; 380: 651–9.
35. Ortega HG, Liu MC, Pavord ID et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med 2014; 371: 1198–207.
36. Bel EH, Wenzel SE, Thompson PJ et al. Oral glucocorticoid-sparing effect of mepoli- zumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–97.
37. Castro M, Zangrilli J, Wechlser ME et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicenter, parallel, double-blind, randomized, placebo-controlled, phase 3 trials. Lancet Respir Med 2015; 3: 355–66.
(GINA) 2018. Available from: http://www.ginasthma.org/
2. Bousqet J, Mantzouranis E, Cruz AA et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol 2010; 126: 926–38.
3. Chung KF, Wenzel S, Brozek J et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43: 343–73.
4. Porsbjerg C, Menzies-Gow A. Co-morbidities in severe asthma: Clinical impact and management. Respirology 2017; 22 (4): 651–61.
5. Hekking PP, Wener RR, Amelink M et al. The prevalence of severe refractory asthma.
J Allergy Clin Immunol 2015; 135 (4): 896–902.
6. Wenzel SE, Vitari CA, Shende M et al. Asthmatic granulomatosis: a novel disease with asthmatic and granulomatous features. Am J Respire Crit Care Med 2012; 186 (Issue 5): 501–7. DOI: 10.1164/rccm.201203-0476OC
7. Ненашева Н.М., Белевский А.С., Фассахов Р.С., Емельянов А.В. Фенотипы трудной для терапии бронхиальной астмы: возможности достижения контроля. РАЖ. 2016; 4–5: 43–54. / Nenasheva N.M., Belevskii A.S., Fassakhov R.S., Emel'ianov A.V. Fenotipy trudnoĭ dlia terapii bronkhial'noi astmy: vozmozhnosti dostizheniia kontrolia. RAZh. 2016; 4–5: 43–54. [in Russian]
8. Luskin AT, Chipps BE, Rasouliyan L et al. Impact of asthma exacerbations and asthma triggers on asthma-related quality of life in patients with severe or difficult-to-treat asthma. J Allergy Clin Immunol Pract 2014; 2 (5): 544–52. DOI: 10.1016/j.jaip.2014.02.011
9. Moore WC, Bleecker ER, Curran-Everett D et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol 2007; 119: 405–13.
10. Haldar P, Pavord I, Shaw D et al. Cluster analysis and clinical asthma phenotypes.
Am J Respir Crit Care Med 2008; 178: 218–24.
11. Moore WC, Meyers DA, Wenzel SE et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010; 181: 315–23.
12. Wenzel S. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18: 716–25.
13. Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med 2013; 19 (8): 977.
14. Сергеева Г.Р., Емельянов А.В., Коровина О.В. и др. Тяжелая бронхиальная астма: характеристика пациентов в клинической практике. Терапевтический архив. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 / Sergeeva G.R., Emel'ianov A.V., Korovina O.V. i dr. Tiazhelaia bronkhial'naia astma: kharakteristika patsientov v klinicheskoi praktike. Therapeutic archive. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 [in Russian]
15. Schleich F, Brusselle G, Louis R et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med 2014; 108: 1723–32.
16. Shau DE, Sousa AR, Fowler SJ et al. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort. Eur Respir J 2015; 46 (5): 1308–21. DOI: 10.1183/13993003.00779-201
17. Kupczyk M, ten Brinke A, Sterk PJ et al. Frequent exacerbators – a distinct phenotype of severe asthma. Clin Exp Allergy 2013; 44: 212–21.
18. Price D, Wilson AM, Chisholm A et al. Predicting frequent asthma exacerbations using blood eosinophil count and other patient data routinely available in clinical practice.
J Asthma Allergy 2016; 9: 1–12. DOI: 10.2147/JAA.S97973
19. Buhl R, Humbert M, Bjermer L et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J 2017; 49. 1700634. DOI: 10.1183/13993003.00634-2017
20. Chung KF, Bel EH, Wenzel SE. Difficult-to-Treat Severe Asthma. European Respiratory Society Monograph 2011; 51.
21. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma. Eur Respir J 2003; 22 (3): 470–7.
22. Desai D, Newby C, Symon FA et al. Elevated sputum interleukin-5 and submucosal eosinophilia in obese individuals with severe asthma. Am J Respir Crit Care Med 2013; 188 (6): 657–63. DOI: 10.1164/rccm.201208-1470OC
23. Moore WC, Hastie AT, Li X et al. National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol 2014; 133 (6): 1557–63.e5. DOI: 10.1016/j.jaci.2013.10.011
24. Denning DW, O’Driscoll BR, Hogaboam CM et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J 2006; 27: 615–26.
25. Denning DW, Pashley C, Hartl D et al. Fungal allergy in asthma-state of the art and research needs. Clin Transl Allergy 2014; 4: 14.
26. Goh KJ, Yil ACA, Lapperre TS et al. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma. J Asthma Allergy 2017; 10: 131–40. DOI: 10.2147/JAA.S130459
27. Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2003; 3: CD001108.
28. Moss RB. Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis. Eur Respir J 2014; 43 (5): 1487–500. DOI: 10.1183/09031936.00139513
29. Ray A, Raundhal M, Oriss T et al. Current concepts of severe asthma. J Clin Invest 2016; 126 (7): 2394–403. DOI: 10.1172/JCI84144
30. Normansell R, Walker S, Milan S et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 20141: CD003559.
31. Rodrigo GJ, Neffen H, Castro-Rodriguez JA. Efficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: a systematic review. Chest 2011; 139 (1): 28–35.
32. Lai T, Wang S, Xu Z et al. Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis. Sci Rep 2015; 5: 8191.
33. Alhossan A, Lee CS, MacDonald K, Abraham I. "Real-life" Effectiveness Studies of Omalizumab in Adult Patients with Severe Allergic Asthma: Meta-analysis. J Allergy Clin Immunol Pract 2017; 5 (5): 1362–70.e2. DOI: 10.1016/j.jaip.2017.02.002.
34. Pavord ID, Korn S, Howarth P et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 2012; 380: 651–9.
35. Ortega HG, Liu MC, Pavord ID et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med 2014; 371: 1198–207.
36. Bel EH, Wenzel SE, Thompson PJ et al. Oral glucocorticoid-sparing effect of mepoli- zumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–97.
37. Castro M, Zangrilli J, Wechlser ME et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicenter, parallel, double-blind, randomized, placebo-controlled, phase 3 trials. Lancet Respir Med 2015; 3: 355–66.
________________________________________________
(GINA) 2018. Available from: http://www.ginasthma.org/
2. Bousqet J, Mantzouranis E, Cruz AA et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol 2010; 126: 926–38.
3. Chung KF, Wenzel S, Brozek J et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43: 343–73.
4. Porsbjerg C, Menzies-Gow A. Co-morbidities in severe asthma: Clinical impact and management. Respirology 2017; 22 (4): 651–61.
5. Hekking PP, Wener RR, Amelink M et al. The prevalence of severe refractory asthma.
J Allergy Clin Immunol 2015; 135 (4): 896–902.
6. Wenzel SE, Vitari CA, Shende M et al. Asthmatic granulomatosis: a novel disease with asthmatic and granulomatous features. Am J Respire Crit Care Med 2012; 186 (Issue 5): 501–7. DOI: 10.1164/rccm.201203-0476OC
7. Nenasheva N.M., Belevskii A.S., Fassakhov R.S., Emel'ianov A.V. Fenotipy trudnoĭ dlia terapii bronkhial'noi astmy: vozmozhnosti dostizheniia kontrolia. RAZh. 2016; 4–5: 43–54. [in Russian]
8. Luskin AT, Chipps BE, Rasouliyan L et al. Impact of asthma exacerbations and asthma triggers on asthma-related quality of life in patients with severe or difficult-to-treat asthma. J Allergy Clin Immunol Pract 2014; 2 (5): 544–52. DOI: 10.1016/j.jaip.2014.02.011
9. Moore WC, Bleecker ER, Curran-Everett D et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol 2007; 119: 405–13.
10. Haldar P, Pavord I, Shaw D et al. Cluster analysis and clinical asthma phenotypes.
Am J Respir Crit Care Med 2008; 178: 218–24.
11. Moore WC, Meyers DA, Wenzel SE et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010; 181: 315–23.
12. Wenzel S. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18: 716–25.
13. Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med 2013; 19 (8): 977.
14. Сергеева Г.Р., Емельянов А.В., Коровина О.В. и др. Тяжелая бронхиальная астма: характеристика пациентов в клинической практике. Терапевтический архив. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 / Sergeeva G.R., Emel'ianov A.V., Korovina O.V. i dr. Tiazhelaia bronkhial'naia astma: kharakteristika patsientov v klinicheskoi praktike. Therapeutic archive. 2015; 12: 22–7. DOI: 10.1136/thx.2010,153643 [in Russian]
15. Schleich F, Brusselle G, Louis R et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med 2014; 108: 1723–32.
16. Shau DE, Sousa AR, Fowler SJ et al. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort. Eur Respir J 2015; 46 (5): 1308–21. DOI: 10.1183/13993003.00779-201
17. Kupczyk M, ten Brinke A, Sterk PJ et al. Frequent exacerbators – a distinct phenotype of severe asthma. Clin Exp Allergy 2013; 44: 212–21.
18. Price D, Wilson AM, Chisholm A et al. Predicting frequent asthma exacerbations using blood eosinophil count and other patient data routinely available in clinical practice.
J Asthma Allergy 2016; 9: 1–12. DOI: 10.2147/JAA.S97973
19. Buhl R, Humbert M, Bjermer L et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J 2017; 49. 1700634. DOI: 10.1183/13993003.00634-2017
20. Chung KF, Bel EH, Wenzel SE. Difficult-to-Treat Severe Asthma. European Respiratory Society Monograph 2011; 51.
21. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma. Eur Respir J 2003; 22 (3): 470–7.
22. Desai D, Newby C, Symon FA et al. Elevated sputum interleukin-5 and submucosal eosinophilia in obese individuals with severe asthma. Am J Respir Crit Care Med 2013; 188 (6): 657–63. DOI: 10.1164/rccm.201208-1470OC
23. Moore WC, Hastie AT, Li X et al. National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol 2014; 133 (6): 1557–63.e5. DOI: 10.1016/j.jaci.2013.10.011
24. Denning DW, O’Driscoll BR, Hogaboam CM et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J 2006; 27: 615–26.
25. Denning DW, Pashley C, Hartl D et al. Fungal allergy in asthma-state of the art and research needs. Clin Transl Allergy 2014; 4: 14.
26. Goh KJ, Yil ACA, Lapperre TS et al. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma. J Asthma Allergy 2017; 10: 131–40. DOI: 10.2147/JAA.S130459
27. Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2003; 3: CD001108.
28. Moss RB. Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis. Eur Respir J 2014; 43 (5): 1487–500. DOI: 10.1183/09031936.00139513
29. Ray A, Raundhal M, Oriss T et al. Current concepts of severe asthma. J Clin Invest 2016; 126 (7): 2394–403. DOI: 10.1172/JCI84144
30. Normansell R, Walker S, Milan S et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 20141: CD003559.
31. Rodrigo GJ, Neffen H, Castro-Rodriguez JA. Efficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: a systematic review. Chest 2011; 139 (1): 28–35.
32. Lai T, Wang S, Xu Z et al. Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis. Sci Rep 2015; 5: 8191.
33. Alhossan A, Lee CS, MacDonald K, Abraham I. "Real-life" Effectiveness Studies of Omalizumab in Adult Patients with Severe Allergic Asthma: Meta-analysis. J Allergy Clin Immunol Pract 2017; 5 (5): 1362–70.e2. DOI: 10.1016/j.jaip.2017.02.002.
34. Pavord ID, Korn S, Howarth P et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet 2012; 380: 651–9.
35. Ortega HG, Liu MC, Pavord ID et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med 2014; 371: 1198–207.
36. Bel EH, Wenzel SE, Thompson PJ et al. Oral glucocorticoid-sparing effect of mepoli- zumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–97.
37. Castro M, Zangrilli J, Wechlser ME et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicenter, parallel, double-blind, randomized, placebo-controlled, phase 3 trials. Lancet Respir Med 2015; 3: 355–66.
Авторы
Н.М.Ненашева*
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1
*1444031@gmail.com
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*1444031@gmail.com
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Москва, ул. Баррикадная, д. 2/1, стр. 1
*1444031@gmail.com
________________________________________________
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*1444031@gmail.com
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.