Optimizing omalizumab dosing in severe asthma—the exploration of therapeutic drug monitoring

Kroes, Johannes A.; Zielhuis, Sander Wilhelm; Meer, Akke-Nynke van der; Jong, Kim de; Roon, E.N. Van; Brinke, Anneke ten

doi:10.1016/j.jaip.2020.12.013

Cited by 7 publications

(8 citation statements)

References 8 publications

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“…This is in concordance with a recent study showing a relationship between omalizumab trough levels and patient-reported need for the next administration. 16 Finally, across all countries, HCPs reported that many patients made a transition to home administration much earlier than might have occurred before the COVID-19 pandemic. Rapid transition to home administration owing to the pandemic has also been reported in other disease areas.…”

Section: Discussionmentioning

confidence: 99%

Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study

Blok

Kocks

Wouters

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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Section: Discussionmentioning

confidence: 99%

Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study

Blok

Kocks

Wouters

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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“…the IL-4/IL-13 pathway. [29,30] Another possible explanation for the residual OCS exposure is adrenal insufficiency which is a major side effect of long-term OCS use. [31] Adrenal insufficiency was not systematically assessed in the study population, which has likely led to an underreporting of adrenal insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Cumulative corticosteroid-sparing effect of anti-interleukin-5/5Ra in eosinophilic asthma

et al. 2022

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IntroductionAnti-interleukin-5/5Ra therapy has shown to reduce maintenance oral corticosteroid dose in severe eosinophilic asthma. However, the effect on cumulative oral corticosteroid exposure is currently unknown. Neither is it known how prior oral corticosteroid exposure affects response to anti-interleukin-5/5Ra treatment. We aimed primarily to compare the cumulative oral corticosteroid exposure over a 2-year period before and after anti-interleukin-5/5Ra initiation, and secondarily to investigate whether duration and cumulative oral corticosteroid exposure prior to anti-interleukin-5/5Ra influence the ability to discontinue oral corticosteroids within 2 years of anti-interleukin-5/5Ra therapy.MethodsThis real-world nationwide observational registry-based study evaluated all dispensed oral corticosteroids from 389 adults with severe eosinophilic asthma included in the Dutch severe asthma registry (RAPSODI) 2 years before and 2 years after initiating anti- interleukin-5/5Ra. Wilcoxon-signed rank test and multivariable regression analyses were used.ResultsMedian (IQR) cumulative oral corticosteroid exposure in the 2 years before and after anti-interleukin-5/5Ra initiation decreased from 2.715 g (1.150–5.539) to 1.050 g (0.300–3.640), p<0.001. Fifty-two percent of patients were able to discontinue oral corticosteroids within 2 years anti-interleukin-5/5Ra therapy, which was independently predicted by lower and shorter prior oral corticosteroid exposure.ConclusionThis real-world study showed that anti-interleukin-5/5Ra therapy leads to a significant reduction in cumulative oral corticosteroid exposure over a 2-year period. Patients with lower and shorter oral corticosteroids exposure were more likely to completely eliminate oral corticosteroids. Since cumulative exposure increased progressively prior to anti-interleukin-5/5Ra initiation, our data suggest that early intervention leads to a better long-term prognosis in patients with severe eosinophilic asthma.

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“…Real-life investigations represent the shift towards personalized medication, based, in this case, primarily on decrease of asthma symptoms and improvement in quality of life [36]. is is also demonstrated from biologicals such as omalizumab (anti-IL-5 in severe asthma); variability in biologic levels has been shown to impact efficacy when also used in other applications of biologicals, e.g., in Inflammatory Bowel Disease [38]: an adapted personalized protocol was needed for more asthma-related benefit [39,40].…”

Section: Discussionmentioning

confidence: 99%

“…He was adequately helped by merely one dose of 15 mg enoximone (personal communication). Dose adaptation should be performed for optimal patient care as reported above for omalizumab [39,45].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Real-Life Investigational Use of Enoximone in Asthma, the Third Step in Drug Repurposing: A Preliminary Report

Beute

Boermans

KleinJan

2021

Canadian Respiratory Journal

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Background. The population of uncontrolled asthma patients represents a large therapeutic burden. The PDE3-inhibitor enoximone is a strong and quick bronchodilator and is known to successfully treat life-threatening bronchial asthma (status asthmaticus). Translational mice models showed anti-inflammatory effects when PDE3 was targeted. Methods. Here, we investigated the effectiveness of PDE3-inhibitor enoximone as oral treatment for chronic asthma in a real-life off-label setting. Investigational use of PDE3-inhibitor enoximone: 51 outpatients (age 18–77) with chronic asthma were followed using off-label personalized low doses of the PDE3-inhibitor enoximone. Duration of treatment was 2–8 years. Results. Four groups could be distinguished as follows: The first group includes patients who use enoximone as an add-on, because it helps them in maintaining a better general wellbeing; they still use their traditional medication (n = 5). The second group consists of patients who use enoximone and were able to phase down their traditional medication without deterioration of their asthma symptoms (n = 11). The third group comprises patients who were able to discontinue their traditional medication and use only enoximone without deterioration of their asthma symptoms (n = 24). The last one has patients who, after having used enoximone for some time, saw their symptoms disappear and now use no medication at all, not even enoximone (n = 11). All patients reported improvement or at least alleviation of their asthma symptoms. All patients reported a better quality of life and greater drug compliance. Conclusion. The evaluation shows that PDE3-inhibitor enoximone is a viable alternative for or addition to current asthma therapeutics, as both add-on and stand-alone, considerably reducing the use of LABAs/SABAs/ICS, with no or negligible side effects. Additional studies are advisable.

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Optimizing omalizumab dosing in severe asthma—the exploration of therapeutic drug monitoring

Cited by 7 publications

References 8 publications

Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study

Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study

Cumulative corticosteroid-sparing effect of anti-interleukin-5/5Ra in eosinophilic asthma

Evaluation of Real-Life Investigational Use of Enoximone in Asthma, the Third Step in Drug Repurposing: A Preliminary Report

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