The Effect of Omalizumab on Eosinophilic Inflammation of the Respiratory Tract in Patients with Allergic Asthma

Kupryś‐Lipińska, Izabela; Molińska, Katarzyna; Kuna, Piotr

doi:10.5603/piap.2016.0029

Cited by 21 publications

(18 citation statements)

References 75 publications

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“…As an add-on treatment, omalizumab has been shown to improve long-term asthma control and lung function, and reduce the use of corticosteroids, rescue medication and frequency of exacerbations in patients with persistent allergic asthma [6][7][8]. Supporting the results from clinical studies, real-world studies conducted in various European countries also reported improvement in asthma control and quality of life of patients after treatment with omalizumab [9][10][11][12]. To strengthen the evidence for omalizumab, a 2-year, global, post-marketing observational registry (eXpeRience) was conducted [13,14].…”

Section: Introductionsupporting

confidence: 65%

Real-world effectiveness and safety of omalizumab in patients with uncontrolled severe allergic asthma from the Czech Republic

Kirchnerová¹,

Valena²,

Novosad³

et al. 2019

pdia

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A b s t r a c tIntroduction: This was a sub-group analysis of patients with uncontrolled persistent allergic asthma (AA) in the healthcare setting of the Czech Republic, from a global non-interventional, 2-year post-marketing, observational eXpeRience registry. Aim: To evaluate the real-life effectiveness and safety of omalizumab. Material and methods: Patients with uncontrolled persistent AA (currently defined by the Global Initiative for Asthma (GINA) as uncontrolled severe AA) who started omalizumab treatment 15 weeks before inclusion in the registry were analysed for physicians' global evaluation of treatment effectiveness (GETE), asthma symptoms, corticosteroid use, exacerbation rate, asthma control, quality of life, healthcare utilisation and safety during a 24-month observation period. Results: One hundred and fourteen patients from the Czech Republic were enrolled in the eXpeRience registry. A total of 88.9% of the patients were evaluated as responders to omalizumab according to the GETE assessment at week 16. From baseline to month 24: mean change in forced expiratory volume in 1 s (FEV 1 ) was 137 ml and the daily dose of OCS decreased (11.6 mg to 6.4 mg prednisolone equivalent); the percentage of patients with no severe clinically significant exacerbations increased (29.5% to 95.1%); Asthma Control Test scores improved (12.4 to 17.3) and mean total number of days of asthma-related medical healthcare use decreased (6.8 days to 0.4 days). Conclusions: The results of this subgroup analysis support the evidence that add-on omalizumab therapy is effective and well tolerated for management of patients with uncontrolled persistent AA in the Czech Republic. Global evaluation of treatment effectiveness assessment is a reliable predictor of long-term response to omalizumab treatment.

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Section: Introductionsupporting

confidence: 65%

Real-world effectiveness and safety of omalizumab in patients with uncontrolled severe allergic asthma from the Czech Republic

Kirchnerová¹,

Valena²,

Novosad³

et al. 2019

pdia

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“…The number of eosinophils in blood and sputum has previously been shown to significantly decrease by omalizumab treatment, which correlated with clinical benefits in terms of asthma exacerbation and lung function. 24 25 26 Omalizumab can reduce eosinophilic inflammation by inhibiting release of cytokines and chemotactic factors for eosinophil activation from mast cells/basophils as well as antigen presentation by dendritic cells. 24 Eosinophilic inflammation is proportionally associated with asthma severity.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Omalizumab in Severe Asthma: A Real-World Study in Korea

Lee

Jung

et al. 2018

Allergy Asthma Immunol Res

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PurposeOmalizumab, an anti-immunoglobulin E (IgE) monoclonal antibody, has proved to be effective for the treatment of severe asthma. However, there is no direct evidence of effectiveness of omalizumab in Korean patients with severe asthma. We sought to evaluate the real-world effectiveness of omalizumab in Korean adult patients suffering from severe asthma and to identify predictors of favorable response.MethodsA retrospective analysis of electrical medical records was performed on severe allergic asthmatic patients with omalizumab treatment group (OT group) for more than 6 months between March 2008 and February 2016. Propensity score matching was applied to define the standardized treatment control group (STC group) treated without omalizumab. Asthma-related outcomes were compared between the 2 groups, and analyzed before and after omalizumab use in the OT group. Responders to treatment were defined as patients showing >50% reduction in asthma exacerbations and/or systemic steroid requirement during the outcome period.ResultsOne hundred twenty-four patients with severe asthma (62 in the OT group; 62 in the STC group) were enrolled in the study. Proportion of patients having the reduction of asthma exacerbation (53.2% vs 35.5%, P=0.015) and the rate of responders (67.7% vs 41.9%, P=0.007) were significantly higher in the OT group than in the STC group. Significant reductions were noted in asthma exacerbation (P=0.006), hospitalization (P=0.009), hospitalization days (P=0.006), systemic corticosteroid requirements (P=0.027), and sputum eosinophil count (P=0.031) in OT group compared with STC group. There were no significant differences in changes of forced expiratory volume in the 1 second (FEV1) levels between the 2 groups. No predictors of responders were found for omalizumab treatment.ConclusionsOmalizumab can reduce exacerbations/hospitalization/systemic steroid burst in Korean adult patients with severe asthma.

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“…Several studies have shown a decrease in the number of circulating eosinophils and bronchial tissue eosinophils in asthmatics treated with omalizumab [ 79 – 82 ]. Patients with steroid-resistant asthma have been shown to have higher levels of eosinophils, and in these cases omalizumab is a very effective treatment, reducing circulating eosinophils [ 83 ]. A proapoptotic effect of omalizumab on eosinophils may contribute to this decrease [ 84 ].…”

Section: Treatment Options For Severe Allergic and Nonallergic Astmentioning

confidence: 99%

Omalizumab for Severe Asthma: Beyond Allergic Asthma

Loureiro

Amaral

Ferreira

et al. 2018

BioMed Research International

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Different subsets of asthma patients may be recognized according to the exposure trigger and the frequency and severity of clinical signs and symptoms. Regarding the exposure trigger, generally asthma can be classified as allergic (or atopic) and nonallergic (or nonatopic). Allergic and nonallergic asthma are distinguished by the presence or absence of clinical allergic reaction and in vitro IgE response to specific aeroallergens. The mechanisms of allergic asthma have been extensively studied with major advances in the last two decades. Nonallergic asthma is characterized by its apparent independence from allergen exposure and sensitization and a higher degree of severity, but little is known regarding the underlying mechanisms. Clinically, allergic and nonallergic asthma are virtually indistinguishable in exacerbations, although exacerbation following allergen exposure is typical of allergic asthma. Although they both show several distinct clinical phenotypes and different biomarkers, there are no ideal biomarkers to stratify asthma phenotypes and guide therapy in clinical practice. Nevertheless, some biomarkers may be helpful to select subsets of atopic patients which might benefit from biologic agents, such as omalizumab. Patients with severe asthma, uncontrolled besides optimal treatment, notwithstanding nonatopic, may also benefit from omalizumab therapy, although currently there are no randomized double-blind placebo controlled clinical trials to support this suggestion. However, omalizumab discontinuation according to each patient's response to therapy and pharmacoeconomical analysis are questions that remain to be answered.

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The Effect of Omalizumab on Eosinophilic Inflammation of the Respiratory Tract in Patients with Allergic Asthma

Cited by 21 publications

References 75 publications

Real-world effectiveness and safety of omalizumab in patients with uncontrolled severe allergic asthma from the Czech Republic

Real-world effectiveness and safety of omalizumab in patients with uncontrolled severe allergic asthma from the Czech Republic

Therapeutic Effect of Omalizumab in Severe Asthma: A Real-World Study in Korea

Omalizumab for Severe Asthma: Beyond Allergic Asthma

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