The anti-IgE antibody omalizumab reduces exacerbations and steroid requirement in allergic asthmatics
Markus Solèr,J. Matz,Robert G. Townley,R. Buhl,J. O'Brien,Howard Fox,J. Thirlwell,N. Gupta,G. Della Cioppa +8 more
TLDR
Results indicate that omalizumab therapy safely improves asthma control in allergic asthmatics who remain symptomatic despite regular use of inhaled corticosteroids and simultaneous reduction in Corticosteroid requirement.Abstract:
The clinical benefit and steroid-sparing effect of treatment with the anti-immunoglobulin-E (IgE) antibody, omalizumab, was assessed in patients with moderate-to-severe allergic asthma. After a run-in period, 546 allergic asthmatics (aged 12-76 yrs), symptomatic despite inhaled corticosteroids (500-1,200 microg daily of beclomethasone dipropionate), were randomized to receive double-blind either placebo or omalizumab every 2 or 4 weeks (depending on body weight and serum total IgE) subcutaneously for 7 months. A constant beclomethasone dose was maintained during a 16-week stable-steroid phase and progressively reduced to the lowest dose required for asthma control over the following 8 weeks. The latter dose was maintained for the next 4 weeks. Asthma exacerbations represented the primary variable. Compared to the placebo group, the omalizumab group showed 58% fewer exacerbations per patient during the stable-steroid phase (p<0.001). During the steroid-reduction phase, there were 52% fewer exacerbations in the omalizumab group versus the placebo group (p<0.001) despite the greater reduction of the beclomethasone dosage on omalizumab (p<0.001). Treatment with omalizumab was well tolerated. The incidence of adverse events was similar in both groups. These results indicate that omalizumab therapy safely improves asthma control in allergic asthmatics who remain symptomatic despite regular use of inhaled corticosteroids and simultaneous reduction in corticosteroid requirement.read more
Citations
More filters
Journal ArticleDOI
International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma
Kian Fan Chung,Sally E. Wenzel,Jan Brozek,Andrew Bush,Mario Castro,Peter J. Sterk,Ian M. Adcock,Eric D. Bateman,Elisabeth H. Bel,Eugene R. Bleecker,Louis-Philippe Boulet,Christopher E. Brightling,Pascal Chanez,Sven-Erik Dahlén,Ratko Djukanovic,Urs Frey,Mina Gaga,Peter G. Gibson,Qutayba Hamid,Nizar N. Jajour,Thais Mauad,Ronald L. Sorkness,W. Gerald Teague +22 more
TL;DR: Recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults and coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy are provided.
Journal ArticleDOI
Asthma phenotypes: the evolution from clinical to molecular approaches
TL;DR: Ongoing studies of large-scale, molecularly and genetically focused and extensively clinically characterized cohorts of asthma should enhance the ability to molecularly understand these phenotypes and lead to more targeted and personalized approaches to asthma therapy.
Journal ArticleDOI
Type 2 inflammation in asthma — present in most, absent in many
TL;DR: How dichotomizing asthma according to levels of type 2 inflammation — into 'T helper 2 (TH2)-high' and 'TH2-low' subtypes (endotypes) — has shaped the thinking about the pathobiology of asthma and has generated new interest in understanding the mechanisms of disease that are independent of type 1 inflammation is considered.
Journal ArticleDOI
Asthma: defining of the persistent adult phenotypes.
TL;DR: This Review analyses some of the methods that have been used to define asthma phenotypes and proposes an integrated method of classification to improve the understanding of these phenotypes.
Journal ArticleDOI
Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE
Marc Humbert,Richard Beasley,J. Ayres,Raymond G. Slavin,Jean-Louis Hébert,Jean Bousquet,K.-M. Beeh,S. Ramos,Giorgio Walter Canonica,S. Hedgecock,Howard Fox,M. Blogg,K. Surrey +12 more
TL;DR: The effect of omalizumab on clinically significant asthma exacerbations (requiring systemic corticosteroids) is determined in the first omalIZumab study to exclusively enrol patients from this difficult‐to‐treat patient population.
References
More filters
Journal ArticleDOI
Association of asthma with serum IgE levels and skin-test reactivity to allergens.
TL;DR: It is concluded that asthma is almost always associated with some type of IgE-related reaction and therefore has an allergic basis, although not all the allergic stimuli that cause asthma appear to have been included in the battery of common aeroallergens the authors used to assess atopic status.
Journal ArticleDOI
Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group
Romain Pauwels,Claes-Göran Löfdahl,Dirkje S. Postma,Anne E. Tattersfield,Paul M. O'Byrne,Peter J. Barnes,A Ullman +6 more
TL;DR: In patients who have persistent symptoms of asthma despite treatment with inhaled glucocorticoids, the addition of formoterol to budesonid therapy or the use of a higher dose of budesonide may be beneficial.
Journal ArticleDOI
Immunologic basis of antigen-induced airway hyperresponsiveness
TL;DR: Current understanding of the pathophysiologic mechanisms by which Th2 cytokines induce airway disease, and the factors that predispose to the generation of these pathogenic cells in response to inhalation of ubiquitous aero-allergens are discussed.
Journal ArticleDOI
Proceedings of the ATS Workshop on Refractory Asthma Current Understanding, Recommendations, and Unanswered Questions
Sally E. Wenzel,John V. Fahy,Charles G. Irvin,Stephen P. Peters,Sheldon L. Spector,Stanley J. Szefler,Thomas B. Casale,Michelle M. Cloutier,Jack A. Elias,Mark C. Liu,Virginia Taggert +10 more
TL;DR: The proceedings of an American Thoracic Society (ATS)-sponsored workshop are hoped to serve as an aid to begin to define, understand, and manage these refractory patients.