Endotypes of severe allergic asthma patients who clinically benefit from Anti-IgE therapy

Huang, Chi-Hsien; Huang, Yu‐Chen; Weng, Chih-Ming; Lee, Meng-Jung; Wang, Chunhua; Kuo, Han‐Pin

doi:10.1183/13993003.congress-2018.pa957

Cited by 10 publications

(27 citation statements)

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“…Total immunoglobulin (Ig) E levels, usually higher compared with “nonallergic” asthma, may overlap between the allergic and “nonallergic” asthma. The atopic background is associated with increased type 2 (T2) cytokines (interleukin (IL)‐4, IL‐13 and IL‐5) and IL‐33, IL‐25 and TSLP potentiate T2 inflammation . Abrogation of IL‐4Rα signalling after established allergic airway disease prevents the development of ovalbumin‐induced airway hyperreactivity, eosinophilia and goblet cell metaplasia .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Agache

Rocha

Beltrán

et al. 2020

Allergy

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Allergic asthma is a frequent asthma phenotype. Both IgE and type 2 cytokines are increased, with some degree of overlap with other phenotypes. Systematic reviews assessed the efficacy and safety of benralizumab, dupilumab and omalizumab (alphabetical order) vs standard of care for patients with uncontrolled severe allergic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthmarelated outcomes were evaluated. The risk of bias and the certainty of the evidence were assessed using GRADE. All three biologicals reduced with high certainty the annualized asthma exacerbation rate: benralizumab incidence rate ratios (IRR) 0.63 (95% CI 0.50 − 0.81); dupilumab IRR 0.58 (95%CI 0.47 − 0.73); and omalizumab IRR 0.56 (95%CI 0.42 − 0.73). Benralizumab and dupilumab improved asthma control with high certainty and omalizumab with moderate certainty; however, none reached the minimal important difference (MID). Both benralizumab and omalizumab improved QoL with high certainty, but only omalizumab reached the MID. Omalizumab enabled ICS dose reduction with high certainty. Benralizumab and omalizumab showed an increase in drug-related adverse events (AEs) with low to moderate certainty. All three biologicals had moderate certainty for an ICER/QALY value above the willingness to pay threshold. There was high certainty that in children 6-12 years old omalizumab decreased the annualized exacerbation rate [IRR 0.57 (95%CI 0.45-0.72)], improved QoL [relative risk 1.43 (95%CI 1.12 −1.83)], reduced ICS [mean difference (MD) −0.45 (95% CI −0.58 to −0.32)] and rescue medication use [ MD −0.41 (95%CI −0.66 to −0.15)]. K E Y W O R D S benralizumab, dupilumab, exacerbations, omalizumabsevere allergic asthma | 1045 AGACHE Et Al.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Agache

Rocha

Beltrán

et al. 2020

Allergy

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“…Nevertheless, about one third of the potentially responder patients, fail to benefit from the treatment, and the reasons are not fully elucidated. It has been recently reported that most of patients affected by severe allergic asthma, who benefited from omalizumab, showed high levels of IL‐33, IL‐25 and TSLP in bronchial tissues, whereas a mixed eosinophilic and neutrophilic airway inflammation is predominantly found in non responders . These findings strongly support the concept that an optimal characterization of both endotype and phenotype of the disease is mandatory to drive the choice of the right treatment.…”

Section: Asthmamentioning

confidence: 55%

Biologicals targeting type 2 immunity: Lessons learned from asthma, chronic urticaria and atopic dermatitis

et al. 2019

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During the last decades, progression of research has led to great achievements for treatment and therapy of several disabling disorders, particularly in the field of chronic inflammatory diseases. The increased knowledge of the molecular mechanisms operating in such diseases has represented the first step in this process, and the discovery of molecules able to interfere with the natural history of the diseases, has been the second. This review is focused on the effects of biologics on type 2 diseases such as asthma, chronic urticaria and atopic dermatitis, both biologics just approved for clinical application and also those that are currently undergoing clinical trials. We will also discuss aspects and emphasize clinical trials and recently published studies, as well as research that is currently in the progress, which will be highly relevant for basic immunologists. Likewise, we will cover aspects that are pertinent for clinical immunologists and highlight translational studies that are evaluating novel biologicals in animal models.Keywords: atopic dermatitis r bronchial asthma r chronic urticaria r precision medicine

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“…20 studies with extractable data regarding the effect of mAbs on biomarkers in respiratory mucosa in inflammatory airway conditions. [21][22][23][24][25][26][27][28][29][30][31] Risk of bias within the included studies was considered low 21,22,24,[27][28][29][30] or unclear 21,26,31 in the RCTs ( Figure 2) and moderate in the single-arm trials. 23,25 The risk of bias assessments of included studies is outlined in Tables S2 and S3.…”

Section: Data Items and Extractionmentioning

confidence: 99%

“…Nine trials were RCTs 21,22,24,[26][27][28][29][30][31] and two were single-arm trials. 23,25 A total of five different mAbs were examined across these trials. The mAbs studied were omalizumab (anti-IgE mAb), 21,23,28,29,31 mepolizumab (anti-IL-5 mAb), 22,25,27 benralizumab (anti-IL-5 receptor-α mAb), 26 dupilumab (anti-IL-4…”

Section: Study Characteristicsmentioning

confidence: 99%

Effect of monoclonal antibody drug therapy on mucosal biomarkers in airway disease: A systematic review

Walter

Alvarado

et al. 2020

Clin Experimental Allergy

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Endotypes of severe allergic asthma patients who clinically benefit from Anti-IgE therapy

Cited by 10 publications

References 0 publications

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma

Biologicals targeting type 2 immunity: Lessons learned from asthma, chronic urticaria and atopic dermatitis

Effect of monoclonal antibody drug therapy on mucosal biomarkers in airway disease: A systematic review

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