Experience of using dupilumab in the treatment of severe bronchial asthma: a clinical case

DOI: https://dx.doi.org/10.18565/pharmateca.2021.10.124-128

G.R. Sergeeva (1), I.V. Tsukanova (2), T.V. Demyanova (3), A.V. Emelyanov (1)

1) North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia; 2) City Outpatient Clinic № 94, Nevsky District, St. Petersburg, Russia; 3) St. Elizabeth Hospital, St. Petersburg, Russia
Background. Treatment of patients with severe bronchial asthma (BA) using immunobiological drugs requires determination of BA phenotypes and endotypes based on the clinical features of the disease and biological markers. Currently, 5 biological drugs are registered in the Russian Federation for the treatment of patients with the T2 endotype of the disease, which can manifest itself as atopic, eosinophilic, hormone-dependent BA phenotypes, or their combination. The experience of using monoclonal antibodies against interleukin 4/13 (dupilumab) for additional treatment of severe AD in real clinical practice is relatively small.
Description of the clinical case. The article presents an experience of 1-year use of dupilumab (600 mg starting dose, then 300 mg every 2 weeks) in a patient with a severe hormone-dependent atopic eosinophilic BA, uncontrolled by high doses of inhaled glucocorticoids in combination with long-acting inhaled β2-adrenomimetics, anticholinergics, and oral steroids, with initially elevated levels of exhaled nitric oxide and low lung function.
Conclusion. During the treatment with dupilumab, there was a significant improvement in the control of the disease and the patient’s quality of life, a decrease in the dose of oral glucocorticoids by more than 2 times, and a significant decrease in the use of health care resources.
Keywords: severe bronchial asthma, biological therapy, dupilumab

About the Autors

Corresponding author: Aleksandr V. Emelyanov, Dr. Sci. (Med.), Professor, Head of the Department of Pulmonology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia; emelav@inbox.ru
Address: 41 Kirochnaya st., St. Petersburg 191015, Russian Federation

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