TY - JOUR

T1 - Организация помощи пациентам с тяжелой бронхиальной астмой, нуждающимся в лечении генно-инженерными биологическими препаратами, в Санкт-Петербурге

AU - Титова , О.Н.

AU - Волчков, Владимир Анатольевич

AU - Кузубова , Наталия Анатольевна

AU - Склярова, Д. Б.

N1 - Export Date: 11 March 2024 Адрес для корреспонденции: Sklyarova, D.B.; City Multidisciplinary Hospital No. 2, 5, Uchebnyy lane, Russian Federation; эл. почта: darya_sklyarova@mail.ru Пристатейные ссылки: Hekking, P.P.W., Wener, R.R., Amelink, M., The prevalence of severe refractory asthma (2015) J Allergy Clin Immunol, 135 (4), pp. 896-902; Bender, B., Oppenheimer, J., George, M., Assessment of Real-World Escalation to Biologics in US Patients With Asthma (2022) J Allergy Clin Immunol Pract, 10 (11), pp. 2941-2948; Broder, M.S., Raimundo, K., Ngai, K.M., Cost and health care utilization in patients with asthma and high oral corticosteroid use (2017) Ann Allergy Asthma Immunol, 118 (5), pp. 638-639; Pavord, I.D., Eosinophilic phenotypes of airway disease (2013) Ann Am Thorac Soc, 10, pp. S143-S149. , (Suppl); Liaqat, A., Mason, M., Foster, B., Evidence-Based Approach of Biologic Therapy in Bronchial Asthma (2023) J Clin Med, 12 (13), p. 4321; Padró-Casas, C., Basagaña, M., Rivera-Ortún, M.L., Characterization and Factors Associated with Poor Asthma Control in Adults with Severe Eosinophilic Asthma (2023) J Pers Med, 13 (7), p. 1173; Hambly, N., Nair, P., Monoclonal antibodies for the treatment ofrefractory asthma (2014) Curr Opin Pulm Med, 20 (1), pp. 87-94; Kerkhof, M., Tran, T.N., Soriano, J.B., Healthcare resource use and costs of severe, uncontrolled eosinophilic asthma in the UK general population (2018) Thorax, 73, pp. 116-124; FitzGerald, J.M., Lemiere, C., Lougheed, M.D., Recognition and management of severe asthma: a Canadian thoracic society position statement (2017) Can J Respir Crit Care Sleep Med, 1 (4), pp. 199-221; Levy, M.L., The national review of asthma deaths: what did we learn and what needs to change? (2015) Breathe, 11 (1), pp. 14-24; Avdeev, S.N., Volkova, O.A., Demko, I.V., Severe bronchial asthma patient care organization in various regions of the Russian Federation. From endotypes and phenotypes of bronchial asthma to personalized choice of therapy (2020) Therapeutic Archive, 92 (2), pp. 119-123. , [(in Russ)]; Demko, I.V., Sobko, E.A., Kraposhina, A.Yu., Shestakova, N.A., Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region (2023) Pulmonologiya, 33 (1), pp. 119-127. , [(in Russ)]; Belevskiy, A.S., Nenasheva, N.M., Kravchenko, N.Yu., Data from the Russian Severe Asthma Registry (RSAR) (2022) Terapevticheskii Arkhiv (Ter Arkh), 94 (7), pp. 865-871. , [(in Russ)]

PY - 2023

Y1 - 2023

N2 - The proportion of patients with severe asthma among asthma patients is approximately 5–10%. Severe asthma is associated with a heavy economic burden and remains a major public health problem. Patients with severe asthma require significant use of healthcare resources, i.e., the rate of exacerbation-related hospital admissions and unscheduled emergency department visits is two-and three-fold, respectively, higher than that in non-severe asthma. The discovery of the molecular mechanisms of asthma pathogenesis allowed the development of biological genetically engineering therapies that provide an effective therapeutic option for severe asthma by improving the quality of life by reducing the rate of exacerbations, improving lung function, and reducing the need for systemic steroids with a good safety profile. Targets for existing biological agents include IgE, interleukins (IL)-4, 5, and 13, and thymic stromal lymphopoietin. These drugs include omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab, which were recently registered in Russia. Pharmacoeconomic analysis demonstrates a reduction in the costs of managing patients with severe asthma who receive targeted therapy despite the financial costs of its implementation. The choice of targeted drug is always a complex task that requires careful assessment of clinical, anamnestic, and laboratory parameters. In addition, monoclonal antibodies are an expensive treatment option. Currently, centers for genetically engineering biological therapies are being created to achieve effective routing and continuity in the management of these patients and to minimize financial costs. © 2023, Meditsina-Inform LLC. All rights reserved.

AB - The proportion of patients with severe asthma among asthma patients is approximately 5–10%. Severe asthma is associated with a heavy economic burden and remains a major public health problem. Patients with severe asthma require significant use of healthcare resources, i.e., the rate of exacerbation-related hospital admissions and unscheduled emergency department visits is two-and three-fold, respectively, higher than that in non-severe asthma. The discovery of the molecular mechanisms of asthma pathogenesis allowed the development of biological genetically engineering therapies that provide an effective therapeutic option for severe asthma by improving the quality of life by reducing the rate of exacerbations, improving lung function, and reducing the need for systemic steroids with a good safety profile. Targets for existing biological agents include IgE, interleukins (IL)-4, 5, and 13, and thymic stromal lymphopoietin. These drugs include omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab, which were recently registered in Russia. Pharmacoeconomic analysis demonstrates a reduction in the costs of managing patients with severe asthma who receive targeted therapy despite the financial costs of its implementation. The choice of targeted drug is always a complex task that requires careful assessment of clinical, anamnestic, and laboratory parameters. In addition, monoclonal antibodies are an expensive treatment option. Currently, centers for genetically engineering biological therapies are being created to achieve effective routing and continuity in the management of these patients and to minimize financial costs. © 2023, Meditsina-Inform LLC. All rights reserved.

KW - eosinophilic phenotype

KW - genetically engineered biological therapy (GEBT)

KW - medical commission

KW - monoclonal antibodies

KW - registry

KW - severe asthma

KW - targeted therapy

KW - type 2 immune response

UR - https://www.mendeley.com/catalogue/c8a0f5d9-8adf-34fd-93af-d7c28c9efb69/

U2 - 10.32364/2587-6821-2023-7-8-3

DO - 10.32364/2587-6821-2023-7-8-3

M3 - статья

VL - 7

SP - 493

EP - 497

JO - Русский медицинский журнал

JF - Русский медицинский журнал

SN - 2225-2282

IS - 8

ER -