Algorithm of biophenotyping and choice of medication for targeted therapy of severe uncontrolled asthma with eosinophilic type of airways inflammation

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Abstract

The article is based on the resolution of the Expert Council, including experts from Russian Association of Allergists and Clinical Immunologists (RAACI) and Russian Respiratory Society (RRS) dated November 20, 2016, and the review of clinical studies results and publications on the biomarker-based diagnosis and biological treatment of severe uncontrolled asthma. The aim of this work is to develop a phenotype-oriented algorithm of diagnostics and treatment of severe asthma, supported by the biomarker testing for subsequent selection of appropriate immunobiological treatment. The article constitutes the summary of results of clinical studies and expert opinions on the treatment of asthma in patients who do not achieve disease control with standard treatment regimens including high doses of inhaled corticosteroids in the combination with long-acting beta-agonists, tiotropium, and medications from other pharmacological groups according to Russian Respiratory Society (2016) and GINA (2016-2017) guidelines. The article summarizes the results of international randomized clinical studies performed to assess safety and efficacy of new class of biological treatments, monoclonal antibodies acting against major cytokines that are responsible for inflammation, in patients with severe asthma, including a new anti-IL-5 antibody, reslizumab (Cinqaero).

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About the authors

N I Ilina

National research center «Institute of Immunology» Federal medical-biological agency

N M Nenasheva

Russian Medical Academy for Continuous Professional Education

Email: 1444031@gmail.com

S N Avdeev

National research center «Institute of Pulmonology» Federal medical-biological agency

Z R Aisanov

National research center «Institute of Pulmonology» Federal medical-biological agency

V V Arkhipov

Russian Medical Academy for Continuous Professional Education

A A Vizel

Kazan state medical university

A V Emelyanov

North-Western State Medical University named after I.I. Mechnikov

N P Knyazheskaya

The Pirogov Russian National Research Medical University

O M Kurbacheva

National research center «Institute of Immunology» Federal medical-biological agency

I V Leshchenko

Ural State Medical University

G L Osipova

National research center «Institute of Pulmonology» Federal medical-biological agency

E A Styrt

Russian Medical Academy for Continuous Professional Education

O N Titova

The 1st Saint Petersburg Pavlov state medical university, Scientific research institute of pulmonology

R S Fassakhov

The Kazan Federal University

S V Fedosenko

«Teva» LLC

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