Avaliação de novos alvos terapêuticos para o tratamento da asma moderada e grave em crianças e adolescentes
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Publicado
Feb 14, 2025
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Resumo
Objetivo: Discorrer sobre as novas medidas terapêuticas utilizadas para o tratamento da Asma Grave em crianças e adolescentes, destacando aspectos positivos e fragilidades, mecanismo de ação dos imunobiológicos, sua eficácia e segurança. Métodos: Realizou-se, uma revisão integrativa da literatura por meio de artigos publicados nos últimos cinco anos, disponíveis nas plataformas “Science direct”, “National Library of Medicine” e “Biblioteca Virtual em Saúde". A estratégia de busca retornou 30 artigos, desses 22 foram incluídos. Foi utilizado como descritores severe asthma, treatment, monoclonal antibodies, children. Critérios de inclusão e exclusão foram elencados. Resultados: Após análise dos trabalhos selecionados, observou-se que os fármacos mais utilizados para este tratamento têm proporcionado melhora de sintomas e diminuição de exacerbações e internação da asma em pacientes pediátricos e adolescentes. Conclusão: Os estudos recentes destacam que os imunobiológicos são drogas promissoras para o tratamento de asma moderada e grave, trazendo inúmeros benefícios para o manejo do paciente, visto que, bloqueiam ou diminuem os estímulos que desencadeiam os sintomas da asma, melhora o volume expiratório forçado no primeiro segundo (VEF1), diminuem a possibilidades de agravamentos e são eficazes e seguros para uso pediátrico.
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Como Citar
LucenaM. M. N. de, SousaA. C. da R., FerreiraS. R. D., SilvaE. R. da, CarvalhoR. M. C. de, NascimentoR. F. do, LandimE. C. S., & MacêdoC. L. (2025). Avaliação de novos alvos terapêuticos para o tratamento da asma moderada e grave em crianças e adolescentes. Revista Eletrônica Acervo Saúde, 25, e18604. https://doi.org/10.25248/reas.e18604.2025
Seção
Revisão Bibliográfica
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Referências
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2. AZMEH R, et al. Update in pediatric asthma: selected issues. Dis Mon., 2020; 66(4): 100886.
3. BACHARIER L, et al. Dupilumab Improves Lung Function Parameters in Pediatric Type 2 Asthma: VOYAGE Study. The Journal of Allergy and Clinical Immunology, Estados Unidos, v. 12, ed. 4, p. 948-959, abril 2024.
4. CASTRO M, et al. Reslizumab for poorly controlled, eosinophilic asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med, 2011; 184: 1125-32.
5. CASTRO M, et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med, 2015; 3: 355-66.
6. CHEN M, et al. No difference in omalizumab efficacy in patients with asthma by number of asthma-related and allergic comorbidities. Ann Allergy Asthma Immunol., Estados Unidos, ano 2020, n. 126, ed. 1, p. 666-673, Jan. 2021.
7. CHUNG KF. Visando a via das interleucinas no tratamento da asma. Lancet, 2015; 386: 1086–1096. DOI: 10.1016/s0140-6736 (15)00157-9.
8. CHUNG KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. Eur Respir J. 2014 Fev; 43(2): 343–73.
9. CORREN, JONATHAN et al. Dupilumab Efficacy in Patients with Uncontrolled, Moderate-to-Severe Allergic Asthma. The Journal of Allergy and Clinical Immunology, Reino Unido, v. 8, ed. 2, p. 516-526, fevereiro 2020.
10. CORREN, JONATHAN et al. Efficacy of Tezepelumab in Severe, Uncontrolled Asthma: Pooled Analysis of the PATHWAY and NAVIGATOR Clinical Trials. American Journal of Respiratory and Critical Care Medicine, Estados Unidos, v. 208, ed. 1, p. 13-24, julho de 2023.
11. DOROUDCHI A. et al. Asthma biologics: Comparing trial designs, patient cohorts and study results. Ann Allergy Asthma Immunol., 2020; 124(1): 44-56.
12. FARNE AH, et al. Anti-IL5 therapies for asthma. Cochrane Database Of Systematic Reviews, 2017; 9(9).
13. FIOCCHI, ALESSANDRO et al. Dupilumab leads to better-controlled asthma and quality of life in children: the VOYAGE study. European Respiratory Journal, Estados Unidos, v. 62, ed. 5, p. 1-10, novembro de 2023.
14. Global Initiative for Asthma. Global for Asthma Management and prevention (2024): https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
15. JACKSON, DAVID et al. Ability of Serum IgE Concentration to Predict Exacerbation Risk and Benralizumab Efficacy for Patients with Severe Eosinophilic Asthma. Springer, Reino Unido, v. 37, ed. 12, p. 718-729, Dezembro 2019.
16. JUNIOR A, , et al. The multidisciplinary vision of the quality of life of asthma children. Brazilian Journal of Health Review, [S. l.], v. 3, n. 4, p. 8757–8766, 2020. DOI: 10.34119/bjhrv3n4-120.
17. KARDAS G. et al. Monoclonal antibodies in the management of asthma: Dead ends, current status and future perspectives. Frontiers in Immunology, 2022; 13: 983852.
18. KOFI J, et al. National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. 2020 Focused updates to the asthma management guidelines [homepage]. Washington: U.S. Department of Health and Human.
19. LIBERATI A, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine, 6(7), e1000100.
20. LICARI A, et al. Immunomodulation in Pediatric Asthma. Frontiers In Pediatrics, 2019. 7: 289.
21. LOVINSKY‐DESIR S. The use of biologic therapies for the management of pediatric asthma. Pediatric Pulmonology, 2019; 55(3): 803-808.
22. MCGREGOR M. C. et al. Role of Biologics in Asthma. American Journal of Respiratory and Critical Care Medicine, 2018; 199(4), 433-445.
23. MARQUES G. A.; Wendt A.; Wehrmeister F. C. Temporal evolution of and factors associated with asthma and wheezing in schoolchildren in Brazil. J bras pneumol, [Internet]. 2019; 45(3): e20180138.
24. MARQUES C, et al. Epidemiologia da Asma no Brasil, no período de 2016 a 2020. Research, Society and Development, [S. l.], v. 11, n. 8, p. e5211828825, 2022. DOI: 10.33448/rsd-v11i8.28825.
25. MIRRA V, et al. Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment. BMC Pediatrics, 2018; 18(1).
26. NAIR PARAMESWARAN, et al. Efficacy of Intravenous Reslizumab in Oral Corticosteroid-Dependent Asthma. The Journal of Allergy and Clinical Immunology, Canadá, v. 8, ed. 2, p. 555-564, fevereiro de 2020.
27. NAKAMURA N, et al. Real-life long-term safety and effectiveness of omalizumab in Japanese pediatric patients with severe allergic asthma:A post-marketing surveillance. Japanese Society of Allergology, Japão, v. 70, n. 3, p. 319-326, Julho 2021
28. PAVORD ID, et al. Tezepelumab reduces exacerbations across all seasons in patients with severe, uncontrolled asthma (NAVIGATOR). Ann. Allergy Asthma Immunol. 2023 Nov;131(5):587-597.e3. doi: 10.1016/j.anai.2023.08.015. Epub 2023 Aug 23. PMID: 37619779.
29. PAVORD IAN, et al. Baseline FeNO Independently Predicts the Dupilumab Response in Patients With Moderate-to-Severe Asthma. The Journal of Allergy and Clinical Immunology, Reino Unido, v. 11, ed. 4, p. 1213-1220, abril 2023. (2)
30. PATEL SJ, Teach SJ. Asthma. Pediatr Rev., 2019; 40(11): 549-67.
31. SARINHO, FW et al. Guia prático para o uso de imunobiológicos em doenças alérgicas - ASBAI. Associação Brasileira de Alergia e Imunologia. Vol. 7, N° 4, 2023.
32. VOTTO M, et al. Biological Therapies in Children and Adolescents with Severe Uncontrolled Asthma: a practical review. Biologics: Targets and Therapy, 2021; 15: 133-142.
33. WEDNER H. JAMES, et al. Benralizumab in children with severe eosinophilic asthma: Pharmacokinetics and long-term safety (TATE study). Pediatric Allergy and Immunology, Estados Unidos, v. 35, ed. 3, p. 2-12, março 2024.
34. WALSH GM. Profile of reslizumab in eosinophilic disease and its potential in the treatment of poorly controlled eosinophilic asthma. Biologics, 2013; 7: 7-11.
35. ZHU Rui, et al. Population‐Based Pharmacodynamic Modeling of Omalizumab in Pediatric Patients with Moderate to Severe Persistent Inadequately Controlled Allergic Asthma. The AAPS Journal, Estados Unidos, v. 25, n. 56, p. 1-8, Jun. 2023.
2. AZMEH R, et al. Update in pediatric asthma: selected issues. Dis Mon., 2020; 66(4): 100886.
3. BACHARIER L, et al. Dupilumab Improves Lung Function Parameters in Pediatric Type 2 Asthma: VOYAGE Study. The Journal of Allergy and Clinical Immunology, Estados Unidos, v. 12, ed. 4, p. 948-959, abril 2024.
4. CASTRO M, et al. Reslizumab for poorly controlled, eosinophilic asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med, 2011; 184: 1125-32.
5. CASTRO M, et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med, 2015; 3: 355-66.
6. CHEN M, et al. No difference in omalizumab efficacy in patients with asthma by number of asthma-related and allergic comorbidities. Ann Allergy Asthma Immunol., Estados Unidos, ano 2020, n. 126, ed. 1, p. 666-673, Jan. 2021.
7. CHUNG KF. Visando a via das interleucinas no tratamento da asma. Lancet, 2015; 386: 1086–1096. DOI: 10.1016/s0140-6736 (15)00157-9.
8. CHUNG KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. Eur Respir J. 2014 Fev; 43(2): 343–73.
9. CORREN, JONATHAN et al. Dupilumab Efficacy in Patients with Uncontrolled, Moderate-to-Severe Allergic Asthma. The Journal of Allergy and Clinical Immunology, Reino Unido, v. 8, ed. 2, p. 516-526, fevereiro 2020.
10. CORREN, JONATHAN et al. Efficacy of Tezepelumab in Severe, Uncontrolled Asthma: Pooled Analysis of the PATHWAY and NAVIGATOR Clinical Trials. American Journal of Respiratory and Critical Care Medicine, Estados Unidos, v. 208, ed. 1, p. 13-24, julho de 2023.
11. DOROUDCHI A. et al. Asthma biologics: Comparing trial designs, patient cohorts and study results. Ann Allergy Asthma Immunol., 2020; 124(1): 44-56.
12. FARNE AH, et al. Anti-IL5 therapies for asthma. Cochrane Database Of Systematic Reviews, 2017; 9(9).
13. FIOCCHI, ALESSANDRO et al. Dupilumab leads to better-controlled asthma and quality of life in children: the VOYAGE study. European Respiratory Journal, Estados Unidos, v. 62, ed. 5, p. 1-10, novembro de 2023.
14. Global Initiative for Asthma. Global for Asthma Management and prevention (2024): https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
15. JACKSON, DAVID et al. Ability of Serum IgE Concentration to Predict Exacerbation Risk and Benralizumab Efficacy for Patients with Severe Eosinophilic Asthma. Springer, Reino Unido, v. 37, ed. 12, p. 718-729, Dezembro 2019.
16. JUNIOR A, , et al. The multidisciplinary vision of the quality of life of asthma children. Brazilian Journal of Health Review, [S. l.], v. 3, n. 4, p. 8757–8766, 2020. DOI: 10.34119/bjhrv3n4-120.
17. KARDAS G. et al. Monoclonal antibodies in the management of asthma: Dead ends, current status and future perspectives. Frontiers in Immunology, 2022; 13: 983852.
18. KOFI J, et al. National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. 2020 Focused updates to the asthma management guidelines [homepage]. Washington: U.S. Department of Health and Human.
19. LIBERATI A, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine, 6(7), e1000100.
20. LICARI A, et al. Immunomodulation in Pediatric Asthma. Frontiers In Pediatrics, 2019. 7: 289.
21. LOVINSKY‐DESIR S. The use of biologic therapies for the management of pediatric asthma. Pediatric Pulmonology, 2019; 55(3): 803-808.
22. MCGREGOR M. C. et al. Role of Biologics in Asthma. American Journal of Respiratory and Critical Care Medicine, 2018; 199(4), 433-445.
23. MARQUES G. A.; Wendt A.; Wehrmeister F. C. Temporal evolution of and factors associated with asthma and wheezing in schoolchildren in Brazil. J bras pneumol, [Internet]. 2019; 45(3): e20180138.
24. MARQUES C, et al. Epidemiologia da Asma no Brasil, no período de 2016 a 2020. Research, Society and Development, [S. l.], v. 11, n. 8, p. e5211828825, 2022. DOI: 10.33448/rsd-v11i8.28825.
25. MIRRA V, et al. Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment. BMC Pediatrics, 2018; 18(1).
26. NAIR PARAMESWARAN, et al. Efficacy of Intravenous Reslizumab in Oral Corticosteroid-Dependent Asthma. The Journal of Allergy and Clinical Immunology, Canadá, v. 8, ed. 2, p. 555-564, fevereiro de 2020.
27. NAKAMURA N, et al. Real-life long-term safety and effectiveness of omalizumab in Japanese pediatric patients with severe allergic asthma:A post-marketing surveillance. Japanese Society of Allergology, Japão, v. 70, n. 3, p. 319-326, Julho 2021
28. PAVORD ID, et al. Tezepelumab reduces exacerbations across all seasons in patients with severe, uncontrolled asthma (NAVIGATOR). Ann. Allergy Asthma Immunol. 2023 Nov;131(5):587-597.e3. doi: 10.1016/j.anai.2023.08.015. Epub 2023 Aug 23. PMID: 37619779.
29. PAVORD IAN, et al. Baseline FeNO Independently Predicts the Dupilumab Response in Patients With Moderate-to-Severe Asthma. The Journal of Allergy and Clinical Immunology, Reino Unido, v. 11, ed. 4, p. 1213-1220, abril 2023. (2)
30. PATEL SJ, Teach SJ. Asthma. Pediatr Rev., 2019; 40(11): 549-67.
31. SARINHO, FW et al. Guia prático para o uso de imunobiológicos em doenças alérgicas - ASBAI. Associação Brasileira de Alergia e Imunologia. Vol. 7, N° 4, 2023.
32. VOTTO M, et al. Biological Therapies in Children and Adolescents with Severe Uncontrolled Asthma: a practical review. Biologics: Targets and Therapy, 2021; 15: 133-142.
33. WEDNER H. JAMES, et al. Benralizumab in children with severe eosinophilic asthma: Pharmacokinetics and long-term safety (TATE study). Pediatric Allergy and Immunology, Estados Unidos, v. 35, ed. 3, p. 2-12, março 2024.
34. WALSH GM. Profile of reslizumab in eosinophilic disease and its potential in the treatment of poorly controlled eosinophilic asthma. Biologics, 2013; 7: 7-11.
35. ZHU Rui, et al. Population‐Based Pharmacodynamic Modeling of Omalizumab in Pediatric Patients with Moderate to Severe Persistent Inadequately Controlled Allergic Asthma. The AAPS Journal, Estados Unidos, v. 25, n. 56, p. 1-8, Jun. 2023.