度普利尤单抗治疗1例重度嗜酸性粒细胞型哮喘患者的个体化处理  

Individualized treatment of dupilumab for a patient with severe eosinophilic asthma

作　　者：明丹丹 金美玲[3] 李晓宇 叶晓芬 MING Dandan;JIN Meiling;LI Xiaoyu;YE Xiaofen(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Pharmacy,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China;Department of Allergy,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032 [2]中山大学附属第五医院药学部,广东珠海519000 [3]复旦大学附属中山医院变态(过敏)反应科,上海200032

出　　处：《上海医药》2023年第19期27-30,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市临床重点专科项目(shslczdzk06504)。

摘　　要：1例重度嗜酸性粒细胞型哮喘患者,血清免疫球蛋白E水平正常,外周血嗜酸性粒细胞计数增高,需长期口服糖皮质激素以控制症状。患者曾接受奥马珠单抗治疗5次,效果不佳,后换用度普利尤单抗,哮喘症状明显改善,但出现外周血嗜酸性粒细胞计数进一步增高的不良反应。停用度普利尤单抗,外周血嗜酸性粒细胞计数下降,但哮喘症状复又加重。综合评估患者病情并权衡疾病加重和药物治疗风险后,决定继续使用度普利尤单抗治疗,但采用个体化的治疗方案,密切监测患者病情和外周血嗜酸性粒细胞计数,及时调整度普利尤单抗治疗的间隔时间,效果颇佳。A patient with severe eosinophilic asthma had normal serum immunoglobulin E level and elevated peripheral blood eosinophil count,to whom long-term oral glucocorticoid therapy was required so as to control symptoms.The patient received omalizumab for 5 times with poor results,and then asthma symptoms were significantly improved after switched to dupilumab,but there were adverse reactions of further increase in peripheral blood eosinophil count.Peripheral eosinophil count decreases when dupilumab was discontinued,but asthma symptoms relapsed.It was decided to continue to use dupilumab treatment after comprehensively assessing the condition and weighing the risk of exacerbation and medication.However,the individualized treatment plan was adopted,the disease condition and peripheral blood eosinophils were closely monitored and the interval of dupilumab treatment was adjusted in time and the effect was quite good.

关 键 词：重度嗜酸性粒细胞型哮喘 度普利尤单抗 嗜酸性粒细胞增多 

分 类 号：R974.3[医药卫生—药品] R562.25[医药卫生—药学]