Aeroallergen Sensitization, Serum IgE, and Eosinophilia as Predictors of Response to Omalizumab Therapy During the Fall Season Among Children with Persistent Asthma

Sheehan, William J.; Krouse, Rebecca Z.; Calatroni, Agustin; Gergen, Peter J.; Gern, James E.; Gill, Michelle A.; Gruchalla, Rebecca S.; Hershey, Gurjit K. Khurana; Kattan, Meyer; Kercsmar, Carolyn M.; Lamm, Carin; Little, Frédéric F.; Makhija, Melanie; Searing, Daniel A.; Zoratti, Edward M.; Busse, William W.; Teach, Stephen J.

doi:10.1016/j.jaip.2020.03.051

Cited by 22 publications

(26 citation statements)

References 21 publications

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“…For patients with BEC 150 to 1500 cells/mL and perennial allergy with a clear history of allergy-provoked asthma symptoms, anti-IgE is recommended as a possible choice in clinical practice, but not as the only treatment option, especially in patients with BEC close to 1500. 110,111 Post hoc data clearly demonstrate that anti-IL-5 (mepolizumab), anti-IL-5Ra (benralizumab), and anti-IL-4/13 (dupilumab) treatments are equally effective in patients with high IgE and low IgE. 17,112,113 There is overlap of eligibility in this group, and generally the higher the BEC, even if a perennial allergy is documented, the more likely a positive response to an anti-eosinophil agent.…”

Section: Biologic Treatment Choice Based On Predictors Of Responsementioning

confidence: 99%

Effective Management of Severe Asthma with Biologic Medications in Adult Patients: A Literature Review and International Expert Opinion

Buhl¹,

Bel

Bourdin

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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Severe asthma often remains uncontrolled despite effective treatments and evidence-based guidelines. A group of global experts in asthma and biologic medications from 9 countries considered the most relevant clinical variables to manage severe asthma in adult patients and guide treatment choice. The resulting recommendations address the investigation of biomarker levels (blood eosinophil count along with fractional concentration of exhaled nitric oxide [FeNO]), clinical features (oral corticosteroid [OCS] dependence, specific comorbid disease entities associated with severe type 2 asthma), and safety considerations. Current evidence suggests that biomarkers, including both blood or sputum eosinophil counts as well as FeNO, add prognostic and predictive value and should be measured in all patients with severe asthma. OCS use is an

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Section: Biologic Treatment Choice Based On Predictors Of Responsementioning

confidence: 99%

Effective Management of Severe Asthma with Biologic Medications in Adult Patients: A Literature Review and International Expert Opinion

Buhl¹,

Bel

Bourdin

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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“…[10][11][12] Therefore, some patients will have persistent severe AEs despite receiving adequate treatment, or in other words, exacerbation-prone asthma (EPA), 11,13 whereas type-2-high inflammation has been associated with AE, it is also more likely to show better treatment response to asthma medications, which are mostly type-2 targeted. 14,15 We can assume that risk factors of the longitudinal AE phenotype need to be investigated separately from risk factors of AE through prospective studies with controlled treatment protocols. 13 In this study, we aimed to describe the distribution of longitudinal AE phenotypes, identify EPA predictors, and examine the effect of the longitudinal clinical course on future AE in children and adolescents with asthma.…”

Section: Introductionmentioning

confidence: 99%

“…Recent severe AE is the most important risk factor for future exacerbation, even after adjusting for demographic and clinical factors 10–12 11,13 whereas type‐2‐high inflammation has been associated with AE, it is also more likely to show better treatment response to asthma medications, which are mostly type‐2 targeted 14,15 13 …”

Section: Introductionmentioning

confidence: 99%

Longitudinal asthma exacerbation phenotypes in the Korean childhood asthma study cohort

Park

Suh

Song

et al. 2022

Pediatric Allergy Immunology

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Background Asthma exacerbation (AE) leads to social and economic costs and long‐term adverse outcomes. We aimed to predict exacerbation‐prone asthma (EPA) in children. Methods The Korean childhood Asthma Study (KAS) is a prospective nationwide pediatric asthma cohort of children aged 5–15 years followed every 6 months. Patients with AE during the 6 months prior to all three visits, with AE prior to one or two visits, and without AE prior to any visit were defined as having EPA, exacerbation‐intermittent asthma (EIA), and exacerbation‐resistant asthma (ERA), respectively. Risk factors and prediction models of EPA were explored. Results Of the 497 patients who completed three visits, 42%, 18%, and 15% had exacerbations prior to visits 1, 2, and 3 and 5%, 47%, and 48% had EPA, EIA, and ERA, respectively. Univariate and multivariable logistic regression revealed forced expiratory volume in 1 s (FEV1) z‐score, forced vital capacity (FVC) z‐score, white blood cell (WBC) count, and asthma control test (ACT) score as relevant EPA risk factors. The EPA prediction model comprised FVC z‐score, WBC count, ACT score, sex, and parental education level (area under the receiver operating characteristic curve [AUROC] 0.841 [95% confidence interval (CI): 0.728–0.954]). Conclusion With appropriate management, AE decreases over time, but persistent AEs may occur. Apart from asthma control level, baseline lung function and WBC count predicted EPA.

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“…В двух рандомизированных клинических исследованиях у пациентов в возрасте от 6 до 20 лет -ICATA (Inner-City Anti-IgE Therapy for Asthma) и PROSE (Preventative Omalizumab or Step-up Therapy for Severe Fall exacerbations) -было показано, что лучшим предиктором ответа на омализумаб является сенсибилизация к более чем 4 группам аллергенов. У пациентов с полисенсибилизацией омализумаб способствовал стойкому контролю симптомов БА [6]. Необходимо учитывать, что уровень эозинофилов и концентрация общего иммуноглобулина Е (IgE) не влияют на ответ пациента на анти-IgEтерапию и не должны быть использованы в качестве кри- териев отбора на терапию омализумабом [1].…”

Section: Introductionunclassified

Genetically Engineered Biologic Drugs in Management of Children with Bronchial Asthma

Зайцева

Tomilova²,

Zaytseva

et al. 2021

Pediatr. farmakol.

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Current article represents the modern clinical guidelines on management of severe bronchial asthma (BA) in children and practical use of genetically engineered biologic drugs. Clinical efficacy and safety of omalizumab has its special role. Efficacy analysis was carried out in real-life' clinical setting (considering high economical expenses of biological treatment) to estimate effective response predictors and principles of patients selection for such therapy. Two years of anti-IgE treatment experience in inpatient pediatric department settings demonstrates that omalizumab inclusion to treatment of children with severe asthma resistant to standard therapy allows to solve asthma symptoms, to forgo high doses inhaled glucocorticosteroids, to improve lung function parameters, and to increase significantly quality of life in 95% of our patients.

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Aeroallergen Sensitization, Serum IgE, and Eosinophilia as Predictors of Response to Omalizumab Therapy During the Fall Season Among Children with Persistent Asthma

Cited by 22 publications

References 21 publications

Effective Management of Severe Asthma with Biologic Medications in Adult Patients: A Literature Review and International Expert Opinion

Effective Management of Severe Asthma with Biologic Medications in Adult Patients: A Literature Review and International Expert Opinion

Longitudinal asthma exacerbation phenotypes in the Korean childhood asthma study cohort

Genetically Engineered Biologic Drugs in Management of Children with Bronchial Asthma

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