Omalizumab in Japanese children with severe allergic asthma uncontrolled with standard therapy

Odajima, Hiroshi; Ebisawa, Motohiro; Nagakura, Toshikazu; Fujisawa, Takao; Akasawa, Akira; Ito, Komei; Doi, Satoru; Yamaguchi, Koichi; Katsunuma, Toshio; Kurihara, Kazuyuki; Kondo, Naomi; Sugai, Kazuko; Nambu, Mitsuhiko; Hoshioka, Akira; Yoshihara, Shigemi; Sato, Norio; Seko, Noriko; Nishima, Sankei

doi:10.1016/j.alit.2015.05.006

Cited by 44 publications

(28 citation statements)

References 28 publications

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“…In two double-blind, randomized, placebo-controlled trials (RCTs) of children aged 6 to 12 years with moderate-to-severe allergic asthma, treatment with omalizumab reduced the requirement for ICS and protected against disease exacerbations, but there was little change in asthma symptom scores or spirometry [ 9 , 64 ]. These findings were confirmed and extended in older children [ 65 – 67 ].…”

Section: Discussionsupporting

confidence: 54%

Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment

2018

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BackgroundThe primary goal of asthma management is to achieve disease control for reducing the risk of future exacerbations and progressive loss of lung function. Asthma not responding to treatment may result in significant morbidity. In many children with uncontrolled symptoms, the diagnosis of asthma may be wrong or adherence to treatment may be poor. It is then crucial to distinguish these cases from the truly “severe therapy-resistant” asthmatics by a proper filtering process. Herein we report on four cases diagnosed as difficult asthma, detail the workup that resulted in the ultimate diagnosis, and provide the process that led to the prescription of omalizumab.Case presentationAll children had been initially referred because of asthma not responding to long-term treatment with high-dose inhaled steroids, long-acting β2-agonists and leukotriene receptor antagonists. Definitive diagnosis was severe asthma. Three out four patients were treated with omalizumab, which improved asthma control and patients’ quality of life. We reviewed the current literature on the diagnostic approach to the disease and on the comorbidities associated with difficult asthma and presented the perspectives on omalizumab treatment in children and adolescents. Based on the evidence from the literature review, we also proposed an algorithm for the diagnosis of pediatric difficult-to-treat and severe asthma.ConclusionsThe management of asthma is becoming much more patient-specific, as more and more is learned about the biology behind the development and progression of asthma. The addition of omalizumab, the first targeted biological treatment approved for asthma, has led to renewed optimism in the management of children and adolescents with atopic severe asthma.

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Section: Discussionsupporting

confidence: 54%

Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment

2018

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“… Clinically relevant (> 0.5 point) improvement from baseline in the AQLQ and mini-AQLQ scores in 67.2% of patients at month 12 and 60.7% at month 24. Odajima et al, 2015 [ 53 ] multicenter, uncontrolled, open label study Children (6–15 years) with uncontrolled severe allergic asthma ( n = 38) Improved scores of asthma-specific QOL questionnaire for pediatric patients after 24 weeks. Li et al, 2016 [ 54 ] RDBPC, parallel-group, phase III study Patients ≥18 years with uncontrolled moderate-to-severe persistent allergic asthma ( n = 616) Improved overall AQLQ scores and all individual domain scores after 24 weeks.…”

Section: Biologics In Severe Asthmamentioning

confidence: 99%

Severe asthma and quality of life

Hossny

Caraballo

Casale

et al. 2017

World Allergy Organization Journal

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Severe asthma has a great impact on the quality of life (QOL) of patients and their families. The magnitude of this morbidity is affected by several personal factors including age. Appropriate asthma control and modifications of social roles and activities are expected to improve QOL. Biologics, primarily monoclonal antibodies, have been developed to target specific pathways and molecules important in the pathogenesis of asthma. The use of biologics has shown some promising effects on the QOL of patients with severe recalcitrant asthma. Other potential measures involve targeting risk factors and comorbidities and improving the levels of adherence to therapy. This article briefly reviews the impact of severe asthma on QOL and the potential methods to combat this morbidity including the available therapeutic biologics.

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“…In 2 randomized controlled studies of omalizumab, FEV 1 in the omalizumab arm was no better than with the placebo at 24 weeks [8] or 48 weeks [9]. Real-world studies of omalizumab reported that it improved FEV 1 from the baseline at 24 weeks [10] and at 1 year [11], but not at 2 years [12]. For mepolizumab, because of the low prevalence of severe eosinophilic asthma in adolescents, a subgroup analysis of 4 phase II/III mepolizumab trials was recently reported [13].…”

Section: Discussionmentioning

confidence: 99%

Three cases of severe adolescent asthma treated with mepolizumab: lung function trajectories

Hoshi

Matsunaga

Nogami

et al. 2020

Asia Pacific Allergy

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Real-world experience with mepolizumab for pediatric asthma is still limited. We report 3 patients who were treated with mepolizumab for severe adolescent asthma. Two patients, a 12-year-old boy and a 14-year-old girl, responded well to mepolizumab and showed apparent improvement in lung function from a downward trend over time before treatment. The third patient, a 16-year-old boy, whose treatment was switched from omalizumab to mepolizumab, did not have satisfactory response. The 2 successful cases had eosinophil counts of 440 and 371/μL and multiple comorbid allergic diseases including food allergies. The clinical benefit to them included elimination of both exacerbation and exercise-induced asthma. Interestingly, the boy's food-induced gastrointestinal symptoms disappeared following start of mepolizumab treatment.

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Omalizumab in Japanese children with severe allergic asthma uncontrolled with standard therapy

Abstract: In Japanese children with severe allergic asthma, omalizumab decreased free IgE levels to less than 25 ng/mL. Omalizumab improved asthma control and was well-tolerated, as well.

Cited by 44 publications

References 28 publications

Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment

Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment

Severe asthma and quality of life

Three cases of severe adolescent asthma treated with mepolizumab: lung function trajectories

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