Real-World Effectiveness of Omalizumab in Severe Allergic Asthma: A Meta-Analysis of Observational Studies

Impact of prior smoking exposure and COPD comorbidity on treatment response to monoclonal antibodies in patients with severe asthma

“…However, the effects of treatment were not analysed in the SHARP study [ 9 ]. The treatment response found in our study is comparable to real-world data [ 6 – 8 ], which already showed patient responses in the real-world are similar to those in randomised controlled trials (although our study had a more stringent patient selection) [ 6 – 8 ]. In our study, ex-smokers with severe asthma benefited similarly compared to nonsmokers with severe asthma, in all of the selected end-points.…”

“…Despite the prognostic role of smoking in asthma (1), clinical studies of asthma usually exclude current smokers or ex-smokers with a smoking history of >10 pack-years (2)(3)(4)(5). Specifically, the role of humanised monoclonal antibody therapy in patients with severe asthma and prior smoking exposure has not been studied, however, these drugs are used in patients with severe asthma and a history of smoking (6)(7)(8)(9). The aim of the present study was to evaluate in a real-world setting how a history of smoking and comorbid chronic obstructive pulmonary disease (COPD) affect the clinical outcome of patients suffering from severe asthma that are treated with monoclonal antibodies.…”

Precision Medicine for Paediatric Severe Asthma: Current Status and Future Direction

“…[86][87][88] A recent meta-analysis of 86 observational studies confirms real-world efficacy of omalizumab at reducing asthma attacks, and improving patient-reported outcomes and lung function in patients with severe allergic asthma. 89 Discontinuation of omalizumab is associated with a decline in asthma control. 90 Omalizumab reduced the dose of ICS needed to control symptoms and the frequency of asthma attacks during the steroid-reduction phase (18.2 vs 38.5% for placebo) in a double-blind, placebo-controlled RCT in children aged 6-12 years with moderate to severe allergic asthma.…”

Recent Insights into the Management of Inflammation in Asthma

“…Targets, Eligibility, Dosing Regimen and Real World Impact Biologic Name Molecular Target Eligibility Criteria for Adults (Based on EMA) 1–5 Dosing Regimen Real World Impacts Omalizumab Free IgE As add-on therapy to improve asthma control in patients with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and who have reduced lung function (FEV1 <80%) as well as frequent daytime symptoms or night-time awakenings and who have had multiple documented severe asthma exacerbations despite daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist. 2–4 weekly, subcutaneously based on Total IgE level and body weight Improvement in FEV 1 , Asthma control, exacerbations, OCS requirements, healthcare utilisation 26 , 211 , 221 Mepolizumab IL-5 Severe refractory eosinophilic asthma 100mg, 4 weekly, subcutaneously Improvement in asthma control, exacerbations, OCS requirements, healthcare utilisation, AQLQ, FEV 1 26 , 117 , 239 , 241 , 275 Reslizumab IL-5 Severe eosinophilic asthma inadequately controlled despite high dose inhaled corticosteroids plus another medicinal product for maintenance treatment. 3mg/kg 4 weekly, intravenously over 20–50 minutes Improvement in exacerbations, OCS requirements, FEV 1 , healthcare utilisation 233 , 240 Benralizumab Alpha subunit of IL-5 receptor As an add on maintenance treatment in adult patients with severe eosinophilic asthma inadequately controlled despite high-dose inhaled corticosteroids plus long acting β agonists.…”