Real-World Effectiveness of Omalizumab Treatment in Adult Asthma Patients.

IF 2.8 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Jae-Hyuk Jang, ChulHyoung Park, Chungsoo Kim, Youngsoo Lee, Eunyoung Lee, Rae Woong Park, Hae-Sim Park
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引用次数: 0

Abstract

Purpose: Omalizumab improves clinical outcomes for patients with severe asthma (SA), but its long-term effectiveness and potential biomarkers for predicting patient response require further investigation. This study aimed to evaluate the real-world effectiveness of omalizumab in treating SA and to identify potential biomarkers for predicting a favorable treatment response.

Materials and methods: Clinical outcomes were compared between asthma patients receiving omalizumab (omalizumab group) and those on inhaled corticosteroid with long-acting beta-agonist (ICS-LABA) alone (ICS-LABA group). Propensity score matching and Cox proportional hazards model were used to calculate hazard ratios (HRs). Study outcomes included severe asthma exacerbation (SAE), incompletely controlled asthma, intravenous (IV) corticosteroid use, and asthma-related hospitalization. Incompletely controlled asthma was defined by blood eosinophil counts ≥150 cells/µL, fractional exhaled nitric oxide (FeNO) ≥25 ppb, forced expiratory volume in one second (FEV1%) <80%, or SAE occurrence.

Results: The omalizumab group had significantly lower risks of SAE (HR 0.17, p=0.03), incompletely controlled asthma (HR 0.56, p=0.04), IV corticosteroid treatment (HR 0.38, p=0.02), and asthma-related hospitalization (HR 0.27, p=0.05). Blood eosinophil count stayed lower in the omalizumab group. FEV1% was higher with the omalizumab group, while blood neutrophil count, FeNO, and serum total IgE showed no differences. Furthermore, subgroup analysis showed patients with treatment-favorable response (>50% reduction in systemic corticosteroid dose) exhibited decreased blood neutrophil counts but increased FEV1% and serum total IgE levels compared with the treatment-unfavorable group.

Conclusion: Omalizumab treatment effectively reduces SAE and improves lung function and asthma control. Blood neutrophil counts and serum total IgE may be potential biomarkers for predicting favorable responses to omalizumab treatment.

Abstract Image

Abstract Image

Abstract Image

Omalizumab治疗成人哮喘患者的实际疗效。
目的:Omalizumab改善了严重哮喘(SA)患者的临床结果,但其长期有效性和预测患者反应的潜在生物标志物需要进一步研究。本研究旨在评估omalizumab治疗SA的实际有效性,并确定预测良好治疗反应的潜在生物标志物。材料与方法:比较奥玛珠单抗组(omalizumab组)与吸入性皮质类固醇联合长效β激动剂(ICS-LABA)组(ICS-LABA组)哮喘患者的临床结局。采用倾向评分匹配和Cox比例风险模型计算风险比(hr)。研究结果包括严重哮喘加重(SAE)、哮喘不完全控制、静脉注射(IV)皮质类固醇和哮喘相关住院。不完全控制哮喘的定义是血嗜酸性粒细胞计数≥150个细胞/µL,呼气一氧化氮分数(FeNO)≥25 ppb, 1秒用力呼气量(FEV1%)。结果:奥玛单抗组SAE (HR 0.17, p=0.03),不完全控制哮喘(HR 0.56, p=0.04), IV皮质类固醇治疗(HR 0.38, p=0.02)和哮喘相关住院(HR 0.27, p=0.05)的风险显著降低。奥玛珠单抗组血液嗜酸性粒细胞计数保持较低。omalizumab组FEV1%较高,而血液中性粒细胞计数、FeNO和血清总IgE无差异。此外,亚组分析显示,与治疗不利组相比,治疗有利的患者(全身皮质类固醇剂量减少50%)表现出血液中性粒细胞计数减少,但FEV1%和血清总IgE水平升高。结论:Omalizumab治疗可有效降低SAE,改善肺功能和哮喘控制。血液中性粒细胞计数和血清总IgE可能是预测对奥玛珠单抗治疗有利反应的潜在生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Yonsei Medical Journal
Yonsei Medical Journal 医学-医学:内科
CiteScore
4.50
自引率
0.00%
发文量
167
审稿时长
3 months
期刊介绍: The goal of the Yonsei Medical Journal (YMJ) is to publish high quality manuscripts dedicated to clinical or basic research. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, case reports, brief communications, and letters to the Editor.
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