Biológicos en la EPOC

Bernardino Alcázar Navarrete

Resumen


La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una enfermedad extremadamente frecuente y que origina una elevada carga de mortalidad y morbilidad, caracterizada por procesos inflamatorios crónicos que pueden ser subsidiarios de tratamiento con fármacos biológicos . Hasta la fecha, los fármacos estudiados dirigidos a las vías más frecuentemente implicadas en la EPOC (TNF-∝ e IL-1) no han demostrado eficacia clínica. Los esfuerzos  se han dirigido a modular la respuesta inflamatoria eosinofílica  presente en algunos de estos pacientes. Entre los fármacos evaluados, mepolizumab es el que tiene actualmente  evidencia publicada en este ámbito, demostrando una reducción de exacerbaciones frente a placebo en un subgrupo de pacientes.  Actualmente estamos a la espera de nuevos estudios con benralizumab para poder posicionar a estos fármacos en el tratamiento de la EPOC estable.

Texto completo:

PDF HTML

Referencias


Grupo de Trabajo de GesEPOC. Guía de Práctica Clínica

para el Diagnóstico y Tratamiento de Pacientes con

Enfermedad Pulmonar Obstructiva Crónica (EPOC) –

Guía Española de la EPOC (GesEPOC). Versión 2017.

Arch Bronconeumol. 2017;53 Suppl 1:2–64.

Soriano JB, Abajobir AA, Abate KH, Abera SF, Agrawal A,

Ahmed MB, et al. Global, regional, and national deaths,

prevalence, disability-adjusted life years, and years lived

with disability for chronic obstructive pulmonary disease

and asthma, 1990–2015: a systematic analysis for the

Global Burden of Disease Study 2015. Lancet Respir Med.

;5:691–706.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K,

Aboyans V, et al. Global and regional mortality from 235

causes of death for 20 age groups in 1990 and 2010: A

systematic analysis for the Global Burden of Disease Study

Lancet. 2012;380:2095–128.

Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown

J, Carter A, et al. Global, regional, and national disabilityadjusted

life-years (DALYs) for 315 diseases and injuries and

healthy life expectancy (HALE), 1990–2015: a systematic

analysis for the Global Burden of Disease Study 2015.

Lancet. 2016;388:1603–58.

Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H,

Tal-Singer R, et al.; Evaluation of COPD Longitudinally

to Identify Predictive Surrogate Endpoints (ECLIPSE)

Investigators.Susceptibility to Exacerbation in Chronic

Obstructive Pulmonary Disease. N Engl J Med.

;363:1128–38.

Soler-Cataluña J, Martínez García M, Román Sánchez

P, Salcedo E, Navarro M, Ochando R. Severe acute

exacerbations and mortality in patients with chronic

obstructive pulmonary disease. Thorax. 2005;60:925–31.

Woodruff PG, Agustí A, Roche N, Singh D, Martínez FJ.

Current concepts in targeting chronic obstructive pulmonary

disease pharmacotherapy: making progress towards

personalised management. Lancet. 2015;385:1789–98.

Cosio MG, Saetta M, Agustí A. Immunologic aspects of

chronic obstructive pulmonary disease. N Engl J Med.

;360:2445–54.

Postma DS, Rabe KF. The Asthma–COPD Overlap

Syndrome. N Engl J Med. 2015;373:1241–9.

Rennard SI, Fogarty C, Kelsen S, Long W, Ramsdell J,

Allison J, et al.; COPD Investigators. The Safety and

Efficacy of Infliximab in Moderate to Severe Chronic

Obstructive Pulmonary Disease. Am J Respir Crit Care

Med. 2007;175:926–34.

Calverley PMA, Sethi S, Dawson M, Ward CK, Finch

DK, Penney M, et al. A randomised, placebo-controlled

trial of anti-interleukin-1 receptor 1 monoclonal antibody

MEDI8968 in chronic obstructive pulmonary disease.

Respir Res. 2017;18:153.

Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord

ID. Blood eosinophil counts, exacerbations, and response

to the addition of inhaled fluticasone furoate to vilanterol

in patients with chronic obstructive pulmonary disease: a

secondary analysis of data from two parallel randomised

controlled trials. Lancet Respir Med. 2015;3:435–42.

Pavord ID, Lettis S, Locantore N, Pascoe S, Jones PW,

Wedzicha JA, et al. Blood eosinophils and inhaled

corticosteroid/long-acting β-2 agonist efficacy in COPD.

Thorax. 2016;71:118–25.

Vedel-Krogh S, Nielsen SF, Lange P, Vestbo J, Nordestgaard

BG. Blood Eosinophils and Exacerbations in Chronic

Obstructive. Am J Respir Crit Care Med. 2016;193:965–74.

Bafadhel M, Pavord ID, Russell REK. Eosinophils in

COPD: just another biomarker? Lancet Respir Med.

;5:747–59.

Brightling CE, Bleecker ER, Panettieri RA Jr, Bafadhel

M, She D, Ward CK, et al. Benralizumab for chronic

obstructive pulmonary disease and sputum eosinophilia:

a randomised, double-blind, placebo-controlled, phase 2a

study. Lancet Respir Med. 2014;2:891–901.

Pavord ID, Chanez P, Criner GJ, Kerstjens HAM, Korn

S, Lugogo N, et al. Mepolizumab for Eosinophilic

Chronic Obstructive Pulmonary Disease. N Engl J Med.

;377:1613–29.

Benralizumab Efficacy in Moderate to Very Severe Chronic

Obstructive Pulmonary Disease (COPD)- NCT02138916.

:4–7. Disponible en: https://clinicaltrials.gov/ct2/

show/NCT02138916. (Con acceso el 26/04/18)

Efficacy and Safety of Benralizumab in Moderate to

Very Severe Chronic Obstructive Pulmonary Disease-

NCT02155660. 2016:4–7. Disponible en: https://

clinicaltrials.gov/ct2/show/NCT02155660. (Con acceso el

/04/18)


Enlaces refback

  • No hay ningún enlace refback.