Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children

Busse, William W.; Morgan, Wayne J.; Gergen, Peter J.; Mitchell, Herman; Gern, James E.; Liu, Andrew H.; Gruchalla, Rebecca S.; Kattan, Meyer; Teach, Stephen J.; Pongracic, Jacqueline A.; Chmiel, James F.; Steinbach, Suzanne; Calatroni, Augustin; Togias, Alkis; Thompson, Katherine M.; Szefler, Stanley J.; Sorkness, Christine A.

doi:10.1097/01.sa.0000410631.09026.a4

Cited by 43 publications

(64 citation statements)

References 21 publications

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“…In fact, Omalizumab (Xolair®) is a recombinant DNA-derived humanized monoclonal antibody indicated as an add-on therapy in patients aged ≥ 6 years with severe persistent allergic asthma uncontrolled at treatment step 4 or 5 according to guidelines GINA (2). Omalizumab demonstrated to be efficacious both in adults and children (3)(4)(5). In particular, in real-life studies, anti-IgE therapy showed short-and long-term benefits in terms of improving lung function and quality of life, achieving asthma control and reducing symptomatology, severe exacerbations, healthcare resource utilizations, hospitalizations, emergency department visits and reducing or discontinuing other asthma medications thus confirming, complementing, and extending evidence from randomized trials (3,5).…”

Section: Introductionmentioning

confidence: 67%

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Sposato

Scalese

Latorre

et al. 2016

Respiratory Medicine

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Section: Introductionmentioning

confidence: 67%

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Sposato

Scalese

Latorre

et al. 2016

Respiratory Medicine

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“…Severity classification based on medication equivalents for alternative inhaled steroids was established using previous pediatric asthma studies. 25 Institutional review board approval was obtained.…”

Section: Methodsmentioning

confidence: 99%

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Aragona

El-Magbri

Wang

et al. 2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVE:The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus. METHODS:A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (lean ,85%, overweight 85%-95%, obese $95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed. RESULTS:The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0-2.6). When stratified by age, overweight/obese preschool-age children (,5 years) were .2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0-5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups.

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“…Others have shown that 45% of inner-city children with moderate to severe asthma are exposed to mold and 50% to cockroaches (15,21). Routine allergy testing (22), medication changes or addition of allergen-specific immunotherapy (23,24), and public health interventions to assess in-home allergen exposure and reduce or remediate exposures that are found all have the potential to reduce asthma morbidity among high-risk patients (25)(26)(27).…”

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confidence: 99%

Allergen Sensitization Profiles in a Population-Based Cohort of Children Hospitalized for Asthma

Beck¹,

Huang

Kercsmar

et al. 2015

Annals ATS

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Rationale: Allergen sensitization is associated with asthma morbidity. A better understanding of allergen sensitization patterns among children hospitalized for asthma could help clinicians tailor care more effectively. To our knowledge, however, sensitization profiles among children hospitalized for asthma are unknown.Objectives: We sought to describe allergen sensitization profiles and the distribution of self-reported in-home exposures among children hospitalized for asthma. We also sought to assess how sensitization profiles varied by sociodemographic and clinical factors.Methods: This population-based cohort study includes data for 478 children, aged 4-16 years, hospitalized for an asthma exacerbation. Predictors included child age, race, sex, insurance status, reported income, salivary cotinine, exposure to traffic-related air pollution, asthma and atopic history, and season of admission. Outcomes included serum IgE specific to Alternaria alternata/A. tenuis, Aspergillus fumigatus, American cockroach, mouse epithelium, dust mite (Dermatophagoides pteronyssinus and farinae), cat dander, and dog dander (deemed sensitive if IgE > 0.35). Self-reported adverse exposures included mold/mildew, water leaks, cockroaches, rodents, and cracks or holes in the walls or ceiling. Presence of carpeting and furry pets was also assessed.Measurements and Main Results: More than 50% of included patients were sensitized to each of Alternaria, Aspergillus, dust mite, cat dander, and dog dander; 28% were sensitized to cockroach and 18% to mouse. Roughly 68% were sensitized to three or more allergens with evidence of clustering. African American children, compared with white children, were more likely to be sensitized to Alternaria, Aspergillus, cockroach, and dust mite (all P , 0.01). White children were more likely to be sensitized to mouse, cat, and dog (all P , 0.01). Lower income was associated with cockroach sensitization whereas higher income was associated with dog and cat sensitization (all P , 0.01). Atopic history was associated with sensitization to three or more allergens (P , 0.01). Although 42% reported exposure to at least one adverse in-home exposure (and 72% to carpet, 51% to furry pets), only weak relationships were seen between reported exposures and sensitizations.Conclusions: Most children admitted to the hospital for asthma exacerbations are sensitized to multiple indoor allergens. Atopy on the inpatient unit serves as a potential target for improvement in chronic asthma management.

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Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children

Abstract: BACKGROUND-Research has underscored the effects of exposure and sensitization to allergens on the severity of asthma in inner-city children. It has also revealed the limitations of environmental remediation and guidelines-based therapy in achieving greater disease control.

Cited by 43 publications

References 21 publications

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Allergen Sensitization Profiles in a Population-Based Cohort of Children Hospitalized for Asthma

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