Comprehensive efficacy of omalizumab for severe refractory asthma: a time-series observational study

Tajiri, Tomoko; Niimi, Akio; Matsumoto, Hisako; Ito, Isao; Oguma, Tsuyoshi; Otsuka, Kojiro; Takeda, Takumi; Nakaji, Hitoshi; Inoue, Hideki; Iwata, Toshiyuki; Nagasaki, Tadao; Kanemitsu, Yoshihiro; Izuhara, Yumi; Mishima, Michiaki

doi:10.1016/j.anai.2014.06.004

Cited by 75 publications

(68 citation statements)

References 41 publications

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“…Asthma control, asthma-related quality of life, FEV 1 , exacerbations, hospitalizations, and satisfaction with the strategy were not statistically different between groups. 130 Malerba et al enrolled 28 adults with asthma (mean age of 46 years) and compared treatment based on the combination of FeNO and sputum eosinophils to treatment based on clinical score. At 24 months, exacerbation rate and mean symptom scores were lower in the intervention than in the control group.…”

Section: Other Randomized Trials Not Included In Meta-analysismentioning

confidence: 99%

“…Three trials were not included in meta-analysis because of being a cluster trial 128 , focusing on oral corticosteroid tapering strategies 130 and for evaluating a combination of FeNO and sputum eosinophils to guide management 129 . Honkoop et al allocated 611 adults with asthma from primary care clinics to three treatment strategies: (1) aiming at ACQ score <1.50; (2) ACQ score <0.75; and (3) aiming at ACQ score <0.…”

Section: Other Randomized Trials Not Included In Meta-analysismentioning

confidence: 99%

“…Trials were conducted in adults 114,[127][128][129][130][131][132][133] (FeNO cutoffs between 15 and 35 ppb, followup 4 to 12 months), children 95,108,[134][135][136][137][138] (FeNO cutoffs between 20 and 30 ppb, or between 10 and 15 ppb with symptoms, followup 6-12 months), and in pregnant women 139 .…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

See 2 more Smart Citations

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management

Wang¹,

Pianosi²,

Keogh³

et al. 2017

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Section: Other Randomized Trials Not Included In Meta-analysismentioning

confidence: 99%

Section: Other Randomized Trials Not Included In Meta-analysismentioning

confidence: 99%

See 1 more Smart Citation

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management

Wang¹,

Pianosi²,

Keogh³

et al. 2017

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“…Recent studies have shown that long treatment with anti-IgE significantly reduced airway wall thickness and RBM thickness within 6 and 12 months, and this effect was independent of eosinophilic infiltration (21,22). Moreover, in another study, it was demonstrated that 48 weeks of treatment with omalizumab resulted in decrease in airway wall thickness as assessed by computed tomography (72). Accordingly, in a severe asthmatic with persistent airway obstruction possibly associated with airway remodelling, omalizumab may be the first choice.…”

Section: Discussionmentioning

confidence: 92%

Severe Asthma: Anti-IgE or Anti-IL-5?

Bakakos¹,

Loukides²

2015

J Allergy Ther

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Severe asthma is a discrete clinical entity characterised by recurrent exacerbations, reduced quality of life and poor asthma control as ordinary treatment regimens remain inadequate. Difficulty in managing severe asthma derives partly from the multiple existing phenotypes and our inability to recognise them. Though the exact pathogenetic pathway of severe allergic asthma remains unclear, it is known that numerous inflammatory cells and cytokines are involved, and eosinophils represent a key inflammatory cell mediator. Anti-IgE (omalizumab) and anti-IL-5 (mepolizumab) antibodies are biological agents that interfere in different steps of the Th2 inflammatory cascade and are licensed in severe asthma. Both exhibit a favourable clinical outcome as they reduce exacerbation rate and improve asthma control and quality of life, while mepolizumab also induces an oral steroid sparing effect. Nevertheless, it is still questionable which agent is more suitable in the management of severe allergic asthma since no comparable studies have been conducted. Omalizumab's established effectiveness in clinical practice over a long period is complemented by a beneficial effect on airway remodelling process mediated mainly through its impact on eosinophils and other parameters strongly related to eosinophilic inflammation. However, it is possible that mepolizumab through nearly depleting eosinophils could have a similar effect on airway remodelling. Moreover, to date, markers indicative of the patient population responding to each treatment are unavailable although baseline eosinophils and exacerbation rate in the previous year demonstrate a predictive value regarding anti-IL-5 therapy effectiveness. On the other hand, a better therapeutic response for omalizumab has been observed when low forced expiratory volume in 1 sec, high-dose inhaled corticosteroids and increased IgE concentrations are present. Consequently, conclusions are not yet safe to be drawn based on existing knowledge, and additional research is necessary to unravel the remaining issues for the severe asthmatic population.

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“…Об ингибирующем влиянии ОМ на позд-нюю фазу аллергического ответа свидетельствует сниже-ние содержания эозинофилов в индуцированной мокроте и биоптатах слизистой оболочки бронхов, увеличение апоптоза эозинофилов и снижение числа циркулирующих эозинофилов. Представлены и прямые доказательства влияния ОМ на ремоделирование ДП: в нескольких экс-периментальных и клинических исследованиях, проведен-ных недавно, показана связь анти-IgE-терапии с уменьше-нием гиперплазии гладких мышц и толщины стенки брон-хов [4,[12][13][14]. Так, у 8 больных тяжелой АБА до лечения ОМ через 12 и 36 месяцев терапии проводили биопсию бронхов с гистологическим, морфометрическим и проте-омным анализом биоптатов.…”

Section: влияние омализумаба на ремоделирование дыхательных путейunclassified

Omalizumab Rike in Therapy of Grave Therapeutically Resistent Allergic Asthma With Involvement of Small Respiratory Ways and Fixed Bronchial Obstruction. A Literature Review and Clinical Observation

Vorzheva¹,

Хашкина²

2017

Med. sov.

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Comprehensive efficacy of omalizumab for severe refractory asthma: a time-series observational study

Cited by 75 publications

References 41 publications

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management

Severe Asthma: Anti-IgE or Anti-IL-5?

Omalizumab Rike in Therapy of Grave Therapeutically Resistent Allergic Asthma With Involvement of Small Respiratory Ways and Fixed Bronchial Obstruction. A Literature Review and Clinical Observation

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