Omalizumab and long-term quality of life outcomes in patients with moderate-to-severe allergic asthma: a systematic review

Abstract

Background: Asthma is a highly prevalent chronic inflammatory airways disease, with a considerable impact on quality of life (QoL). To express the effects of asthma on patients’ subjective experience, patient-reported outcomes (PROs) represent an important instrument. The asthma QoL questionnaire (AQLQ) is one of the main PROs among these. Materials and methods: To identify long-term asthma-related QoL outcomes associated with omalizumab therapy in patients with moderate-to-severe asthma, we developed a systematic review according to the PRISMA guidelines. Published real-world effectiveness studies of adults or adolescents (12 years or older) with moderate-to-severe allergic asthma treated with omalizumab for at least 48 weeks were reviewed. Sources used were Medline ( PubMed ), the Cochrane Library and Google Scholar up to February 2018. In addition, a cross-referencing search was conducted to complete the revision. Results: A total of 255 potential papers were identified in the first search through the database. After full-text viewing, eight articles were finally included in the review. We summarized the results according to the study design, patient baseline characteristics and effectiveness outcomes assessed by AQLQ score results: variation from baseline to the end of study. Results confirmed the long-term benefits of omalizumab as an add-on therapy in patients with uncontrolled moderate-to-severe allergic asthma. Since there is a lot of evidence on omalizumab effectiveness, we aimed to focus on how a therapy can change patient’s QoL in a long time period. Data showed long-term effects of omalizumab treatment on subjective (PROs) and objective (lung function, corticosteroid use, hospitalizations, asthma exacerbation) effectiveness measures. Conclusion: Studies included in our review were observational trials that, due to their design, present a potential risk of selection bias in the patients included. Beyond this limit, the evaluation of QoL using the AQLQ showed a clear increase over time, following both 48 weeks and 9 years of observation, where QoL improvements still were significant over baseline values.

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

“…Aligned with our results, previous SR of benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab in severe asthma reported a reduction to approximately half of exacerbations, and an improvement in health‐related QoL scores, asthma control and FEV 1 . However, there are some important differences that need to be mentioned.…”

“…Aligned with our results, previous SR of benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab in severe asthma reported a reduction to approximately half of exacerbations, and an improvement in health-related QoL scores, asthma control and FEV 1 . [61][62][63][64][65][66][67][68] However, there are some important differences that need to be mentioned. Previous mepolizumab SR allowed the inclusion of nonapproved doses, 64,65 while the current SR included only licensed doses and routes of administration making the results more applicable to the daily practice.…”

Efficacy predictors of omalizumab in Chinese patients with moderate-to-severe allergic asthma: Findings from a post-hoc analysis of a randomised phase III study

“…However, previous studies have shown strong evidence that omalizumab can provide long-term efficacy in management of allergic asthma. 42 , 43 …”

Response to Omalizumab in Black and White Patients with Allergic Asthma

“…[20][21][22][23] Omalizumab reduces the frequency of clinically significant asthma exacerbations and the requirement for inhaled corticosteroids while improving asthma symptoms, lung function, and asthma-related quality of life. 20,[24][25][26][27] Omalizumab has also been shown to have a favorable safety profile and is well tolerated. 28 Two prospective, randomized, US-based clinical trials evaluating pediatric and adolescent patients with allergic asthma have shown the efficacy of omalizumab in decreasing exacerbations in inner-city populations, which are represented by greater than 90% Black or Hispanic race or ethnicity.…”