Research advance of biological target therapy and its cause of anaphylaxis for common allergic diseases

doi:10.19983/j.issn.2096-8493.20230018

Abstract

Abstract:

With the understanding of pathogenesis, biologics are gradually being applied as a mean of precision medicine for a variety of common allergic diseases, and good therapeutic results have been achieved. However, compared to foreign countries, China has fewer approved drugs and patients’ treatment options are more limited, so expanding the range of drugs and indications is the way forward. As with any emerging drug, safety remains a key issue for biologics, where anaphylaxis, a rapid-onset, life-threatening and serious adverse reaction, have been found to occur in the treatment of a variety of biologics, but it is not well understood or taken seriously enough. The authors therefore review eight biologics used internationally to treat common allergic reactions: omalizumab (anti-IgE), mepolizumab (anti-IL-5), reslizumab (anti-IL-5), benralizumab (anti-IL-5), dupilumab (anti-IL-4, IL-13), tralokinumab (anti-IL-13), nemolizumab (anti-IL-31R) and tesepelumab (anti-TSLP), and summarises the incidence of anaphylaxis to these biologics in order to promote awareness among healthcare professionals, to provide reasonable and necessary supervision after drug administration, and to be able to identify and manage anaphylaxis when they occur.

Key words: Anaphylaxis, Drug hypersensitivity, Biotargeted therapy

CLC Number:

R781.6+7

Ru Yi, Li Lisha, Guan Kai. Research advance of biological target therapy and its cause of anaphylaxis for common allergic diseases[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(2): 169-177. doi: 10.19983/j.issn.2096-8493.20230018

Figures/Tables 2

生物靶向药物	美国				欧盟				日本				中国
生物靶向药物	上市年份	适用患者年龄 (岁)		适应证	上市年份	适用患者年龄 (岁)		适应证	上市年份	适用患者年龄 (岁)		适应证	上市年份	适用患者年龄 (岁)		适应证
奥马珠单抗	2003	≥6	中重度持续性过敏性哮喘		2005	≥6	重度持续性过敏性哮喘		2009	成人与儿童	过敏性哮喘		2018	≥6	中重度持续性过敏性哮喘
	2014	≥12	慢性自发性荨麻疹		2014	≥12	慢性自发性荨麻疹		2017	≥12	慢性自发性荨麻疹
	2020	≥18	鼻息肉		2020	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)		2019	≥12	季节性过敏性鼻炎
美泊利单抗	2015	≥6	重度嗜酸性粒细胞性哮喘		2015	≥6	重度嗜酸性粒细胞性哮喘		2016	≥6	支气管哮喘		2022	≥18	嗜酸性肉芽肿性多血管炎
	2021	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)		2021	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)
雷珠单抗	2016	≥18	重度嗜酸性粒细胞性哮喘		2016	≥18	重度嗜酸性粒细胞性哮喘		尚未批准用于过敏性疾病				尚未批准用于过敏性疾病
本拉珠单抗	2017	≥12	重度嗜酸性粒细胞性哮喘		2018	≥18	重度嗜酸性粒细胞性哮喘		2018	≥18	重度嗜酸性粒细胞性哮喘		尚未批准用于过敏性疾病
度普利尤单抗	2017	≥6	中重度特应性皮炎		2017	≥6	中重度特应性皮炎		2018	≥18	中重度特应性皮炎		2020	≥6	中重度特应性皮炎
	2019	≥6	中重度嗜酸性粒细胞性哮喘		2019	≥6	中重度嗜酸性粒细胞性哮喘		2019	≥12	中重度嗜酸性粒细胞性哮喘
	2019	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)		2019	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)		2020	≥18	重度慢性鼻窦炎伴鼻息肉(CRSwNP)
替塞单抗	2021	≥12	重度哮喘		2021	≥12	重度哮喘		2021	≥12	重度哮喘		尚未批准用于过敏性疾病
曲罗芦单抗	2012	≥18	中重度特应性皮炎		2021	≥12	中重度特应性皮炎		尚未批准用于过敏性疾病				尚未批准用于过敏性疾病
奈莫利珠单抗	尚未批准用于过敏性疾病				尚未批准用于过敏性疾病				2022	≥13	特应性皮炎伴瘙痒		尚未批准用于过敏性疾病

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在医院发生严重过敏反应后的管理措施^[70]	在家中发生严重过敏反应后的管理措施^[71]
立即采取措施	患者自我管理
评估呼吸及循环系统	根据症状体征及时应对
大腿外侧肌肉注射0.3mg肾上腺素	肾上腺素自动注射器
启动紧急医疗服务	严重过敏反应紧急行动计划(下载自 www.AAAAI.org)
将患者置于卧位并尽量抬高下肢
保持气道通畅
给予氧气
建立静脉通路并输注生理盐水
必要时沙丁胺醇雾化吸入
必要时辅助其他药物,如H1抗组胺药或全身糖皮质激素