Arquivos de Asma, Alergia e Imunologia
https://aaai-asbai.org.br/article/doi/10.5935/2526-5393.20230054
Arquivos de Asma, Alergia e Imunologia
Special Article

Guia prático para o uso de imunobiológicos em doenças alérgicas - ASBAI

Practical guide for the use of immunobiologic agents in allergic diseases - ASBAI

Filipe Wanick Sarinho; Norma de Paula Motta Rubini; Aldo José Fernandes Costa; Eduardo Costa de Freitas Silva; Fabrício Prado Monteiro; Faradiba Sarquis Serpa; Marta de Fátima Rodrigues da Cunha Guidacci; Martti Anton Antila; Nelson Guilherme Bastos Cordeiro; Rosana Câmara Agondi; Sérgio Duarte Dortas Júnior; Régis de Albuquerque Campos; Ekaterini Simões Goudouris; Fábio Chigres Kuschnir; João Negreiros Tebyriçá; Nelson Augusto Rosário Filho

http://dx.doi.org/10.5935/2526-5393.20230054 Arq Asma Alerg Imunol, vol.7, n4, p.339-366, 2023
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Resumo

Os anticorpos monoclonais são uma nova classe de medicamentos que representa um marco na evolução da terapia de doenças alérgicas graves. Além de possibilitar uma terapia imunológica alvo específico, proporciona maior controle de sintomas, redução de exacerbações, melhoria da qualidade de vida e da segurança. A eficácia e a segurança dos anticorpos monoclonais no tratamento de doenças alérgicas estão bem documentadas nos estudos clínicos pivotais, de extensão e de vida real. No Brasil, estão licenciados atualmente pela Agência Nacional de Vigilância Sanitária (ANVISA) imunobiológicos para asma, dermatite atópica (DA), esofagite eosinofílica (EoE), granulomatose eosinofílica com poliangeíte (GEPA), rinossinusite crônica com pólipo nasal (RSCcPN), síndromes hipereosinofílicas (SHE) e urticária crônica espontânea (UCE). Com a incorporação do uso dessas novas terapias no dia a dia do médico alergologista e imunologista, naturalmente emergem aspectos práticos que exigem orientações práticas perante as evidências científicas mais atuais, a fim de se manter a boa prática médica, com uso criterioso e consciente pelo especialista capacitado. Assim, nesse guia prático, abordaremos os imunobiológicos aprovados até o momento para doenças alérgicas graves, com objetivo de auxiliar o especialista em Alergia e Imunologia na prescrição e manejo dessas medicações, incluindo indicações, contraindicações, monitoramento da eficácia e segurança, notificação de eventos adversos, bem como aspectos associados aos cuidados com vacinas, populações especiais, acesso, transporte, armazenamento e aplicação domiciliar.

Palavras-chave

Anticorpos monoclonais, asma, urticária, dermatite atópica, esofagite eosinofílica, pólipos nasais.

Abstract

Monoclonal antibodies are a new class of drugs that represent a milestone in the evolution of therapy for severe allergic diseases. In addition to allowing targeted immunologic therapy, they can improve symptom control, reduce exacerbations, and increase quality of life and safety. The efficacy and safety of monoclonal antibodies in the treatment of allergic diseases are well documented in pivotal, extension, and real-life clinical studies. In Brazil, immunobiologic agents are currently licensed by the National Health Surveillance Agency (ANVISA) for use in asthma, atopic dermatitis (AD), eosinophilic esophagitis (EoE), eosinophilic granulomatosis with polyangiitis (EGPA), chronic rhinosinusitis with nasal polyps (CRSwNP), hypereosinophilic syndrome (HES), and chronic spontaneous urticaria (CSU). With the incorporation of these new therapies into the daily practice of the allergist and immunologist, practical aspects will naturally emerge and require practical guidelines in light of the most current scientific evidence in order to maintain good medical practice, with judicious and conscious use by a qualified specialist. Therefore, in this practical guide, we will address the immunobiologic agents currently approved for severe allergic diseases, aiming to assist allergy and immunology specialists in the prescription and practical management of these medications, including indications, contraindications, efficacy and safety monitoring, adverse event reporting, as well as health care factors associated with vaccination, special populations, access, transport, storage, and home use.

Keywords

Monoclonal antibodies, asthma, urticaria, atopic dermatitis, eosinophilic esophagitis, nasal polyps.

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Submitted date:
11/30/2023

Accepted date:
12/14/2023

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