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

Abstract

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. KEYWORDS: severe asthma, eosinophilic phenotype, genetically engineered biological therapy (GEBT), registry, medical commission, targeted therapy, monoclonal antibodies, type 2 immune response. FOR CITATION: Titova O.N., Volchkov V.A., Kuzubova N.A., Sklyarova D.B. Organization of medical care for patients with severe asthma requiring genetically engineered biological therapies in St. Petersburg. Russian Medical Inquiry. 2023;7(8):493–497 (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-3.