Effectiveness of omalizumab in patients 50 years and older with severe persistent allergic asthma

Korn, Stephanie; Schümann, Christian; Kropf, Cornelia; Stoiber, K; Thielen, A.; Taube, Christian; Buhl, Roland

doi:10.1016/j.anai.2010.07.007

Cited by 63 publications

(28 citation statements)

References 32 publications

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“…Proportions of patients having experienced at least one exacerbation ranged from 88.5% (31) to all patients (42,45), averaging between 0.9 and 7.5 exacerbations per patient in the year prior to omalizumab treatment. As many as 96.1% and 86.4% of patients experienced, respectively, daytime symptoms on a daily-and night-time symptoms on a weekly basis (29), confirmed also by the elevated ACT scores reported in several other studies (34, 35, 44-46, 48, 49) The proportion of patients who lost at least 1 day of school or work in the preceding year reached as high as 76.4% (41). Quality-oflife scores were low in four of the six studies that evaluated this variable prior to treatment (28,29,43,50) and the exception were the studies of Vieira et al (44) and Kelmenson et al (46) with small sample sizes, 15 and 4 patients, respectively.…”

Section: Patientssupporting

confidence: 55%

“…Hence, the majority of patients can be estimated to have ranged from about 25 to 70 years of age -covering the predominant adult population. There was a slight preponderance of female patients: there were proportionately more women in 20 of the 23 studies reporting gender distribution (27)(28)(29)(30)(31)(32)(33)(34)(35)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). The majority of patients weighed between 66 kg (44) and 81 kg (45) Omalizumab candidates presented with marked one-year histories of severe exacerbations.…”

Section: Patientsmentioning

confidence: 99%

“…The most common clinical outcome, included in 14 studies, was FEV1 (28,32,34,35,37,39,42,43,(45)(46)(47)(48)(49)(50). Fewer studies reported on other objective (32,34,39,46,49,50) and subjective (29,41) (37,42,50)), and work or school days lost due to asthma (29,32,37,44). Although admittedly overlapping with other assessments in their partial focus on symptom control, asthma-related quality of life using variants of the AQLQ was evaluated in six studies (28,29,37,43,46,50),with the Brusselle et al (28) study also using the EQ5D to permit pharmacoeconomic analysis.…”

Section: Study Designsmentioning

confidence: 99%

See 2 more Smart Citations

‘Real-life’ effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review

Abraham

Alhossan

Lee

et al. 2016

Allergy

111

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We reviewed 24 'real-life' effectiveness studies of omalizumab in the treatment of severe allergic asthma that included 4117 unique patients from 32 countries with significant heterogeneity in patients, clinicians and settings. The evidence underscores the short-and long-term benefit of anti-IgE therapy in terms of the following: improving lung function; achieving asthma control and reducing symptomatology, severe exacerbations and associated work/school days lost; reducing healthcare resource utilizations, in particular hospitalizations, hospital lengths of stay and accident specialist or emergency department visits; reducing or discontinuing other asthma medications; and improving quality of life -thus confirming, complementing and extending evidence from randomized trials. Thus, omalizumab therapy is associated with signal improvements across the full objective and subjective burden of illness chain of severe allergic asthma. Benefits of omalizumab may extend up to 2-4 years, and the majority of omalizumab-treated patients may benefit for many years. Omalizumab has positive short-and longterm safety profiles similar to what is known from randomized clinical trials. Initiated patients should be monitored for treatment response at 16 weeks. Those showing positive response at that time are highly likely to show sustained treatment response and benefit in terms of clinical, quality of life and health resource utilization outcomes.Over the past four decades, the prevalence, morbidity and mortality of asthma have increased significantly (1-4). In particular, severe asthma, which affects about 10% of all patients with asthma, presents with significant morbidity, high healthcare resource utilization and impaired quality of life (5). As there is no cure for asthma, the objective of treatment is to control the clinical aspects of the disease (6). Despite guidelines for the evaluation, classification and management of asthma, most patients and certainly those with severe asthma are controlled suboptimally (7-10).Immunoglobulin E (IgE) is an antibody class associated with hypersensitivity and allergic reactions (11). IgE elicits an immune response by binding mainly to the high-affinity receptor (FceRI) found on the surface of mast cells and basophils. In the mast cell, activation of these receptors through cross-linking with IgE causes the cell to release inflammatory mediators (11).Omalizumab (Xolair Ò , Novartis basel, Switzerland) is a recombinant humanized monoclonal anti-IgE antibody that inhibits the binding of IgE to high-affinity receptors. It is indicated as add-on treatment to inhaled corticosteroids (ICS) and long-acting b2-agonists (LABA). Initial treatment response is evaluated at 16 weeks, and treatment is continued in patients showing a response at that time. Phase III trials with study periods up to 12 months have shown omalizumab to reduce the frequency of asthma exacerbations and concomitant medication burden and improve symptom severity and quality of life, while also being safe (12-15). Effica...

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Section: Patientssupporting

confidence: 55%

Section: Patientsmentioning

confidence: 99%

Section: Study Designsmentioning

confidence: 99%

See 1 more Smart Citation

‘Real-life’ effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review

Abraham

Alhossan

Lee

et al. 2016

Allergy

111

View full text Add to dashboard Cite

show abstract

“…Therefore, it is not well clear if Omalizumab is able to improve significantly asthma control in severe asthmatics older than 65 years. Only one study observed an improvement of asthma outcomes after a short follow-up (4 months) of Omalizumab treatment in asthmatics older than 50 years similarly to patients younger than 50 years (6). However, the doubt about Omalizumab effectiveness in patients older than 65 years, above all in the long term, still remains.…”

Section: Introductionmentioning

confidence: 99%

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Sposato

Scalese

Latorre

et al. 2016

Respiratory Medicine

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“…In one study, patients receiving omalizumab had significantly fewer sleep disturbances compared to patients on salmeterol/fluticasone combination therapy [86]. Two studies of omalizumab as add-on therapy in moderate to severe asthma also demonstrated improvement in nocturnal asthma symptoms [87,88].…”

Section: Omalizumabmentioning

confidence: 99%

Respiratory medications and sleep

Bercovitch

Tsai

2012

Curr Respir Care Rep

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Respiratory physiology is affected by sleep. Patients with chronic lung disease often complain of poor sleep quality. Sleep disturbances may result from poor control of underlying lung disease, thereby disrupting sleep. Sleep disruption may result from hypoventilation resulting in worsened gas exchange. Sleep quality may also be affected by the respiratory medications used to treat certain lung diseases. These medications can have positive effects on sleep by providing better control of underlying respiratory abnormalities and therefore offering better sleep quality. These medications may also have undesirable side effects which can worsen sleep, such as hyperarousal resulting from corticosteroid use. Knowledge of medication effects on sleep is important in management of patients with underlying lung disease. As with all medications, it is important to balance potential benefits with possible negative side effects. This article discusses the effects of common medications used to treat respiratory diseases and their impact on sleep.

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Effectiveness of omalizumab in patients 50 years and older with severe persistent allergic asthma

Cited by 63 publications

References 32 publications

‘Real-life’ effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review

‘Real-life’ effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Respiratory medications and sleep

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