Response to omalizumab in patients with severe allergic asthma: A real-life study. 2017

Louise Zierau, and Emil Schwarz Walsted, and Simon Francis Thomsen, and Vibeke Backer
Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: L_Zierau@hotmail.com.

Omalizumab is a humanized monoclonal anti-IgE antibody, which is widely used for patients with severe uncontrolled asthma. Treatment with omalizumab is known to decrease the number of exacerbations and GETE score (Global Evaluation of Treatment Effectiveness) - but little is known about which patients benefit the most. Moreover, the time to discontinuation of the treatment with omalizumab has yet to be investigated. In this real-life study on a Danish population we explore these important issues. In a retrospective real-life study, 54 patients treated with omalizumab at a specialized outpatient asthma clinic were included. Change in GETE score, time to discontinuation of treatment and associated risk factors were analysed. As a result of omalizumab treatment, most patients improved in GETE score from poor/worsening to excellent. Women were treated for a median time of 31 months (95% CI: 4.6-57.4) and approximately 50% of patients discontinued treatment after 500 days whilst, for men, 50% discontinued treatment after 1500 days. Eosinophil count above 300 cells/μL at treatment initiation was positively related to the discontinuation of omalizumab (HR 4.3 95%CI (1.22-15.28) p = 0.023). In conclusion, female gender and an eosinophil count above 300 cells/μL may predict a better treatment response, leading to a shorter treatment time than the current guideline recommendation of maximum 48 months. Additionally, the GETE score improves with omalizumab. More real-life studies are needed to determine which patients will benefit the most from the treatment.

UI MeSH Term Description Entries
D007958 Leukocyte Count The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells. Blood Cell Count, White,Differential Leukocyte Count,Leukocyte Count, Differential,Leukocyte Number,White Blood Cell Count,Count, Differential Leukocyte,Count, Leukocyte,Counts, Differential Leukocyte,Counts, Leukocyte,Differential Leukocyte Counts,Leukocyte Counts,Leukocyte Counts, Differential,Leukocyte Numbers,Number, Leukocyte,Numbers, Leukocyte
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D012130 Respiratory Hypersensitivity A form of hypersensitivity affecting the respiratory tract. It includes ASTHMA and RHINITIS, ALLERGIC, SEASONAL. Airway Hyperresponsiveness,Hypersensitivity, Respiratory,Airway Hyper-Responsiveness,Airway Hyper Responsiveness,Airway Hyperresponsivenesses,Hyper-Responsiveness, Airway,Hyperresponsiveness, Airway,Respiratory Hypersensitivities
D004802 Eosinophilia Abnormal increase of EOSINOPHILS in the blood, tissues or organs. Eosinophilia, Tropical,Hypereosinophilia,Tropical Eosinophilia,Hypereosinophilias,Tropical Eosinophilias
D004804 Eosinophils Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. Eosinophil
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069444 Omalizumab An anti-IgE, recombinant, humanized monoclonal antibody which specifically binds to the C epsilon3 domain of IMMUNOGLOBULIN E, the site of high-affinity IgE receptor binding. It inhibits the binding of IgE to MAST CELLS and BASOPHILS to reduce the severity of the allergic response and is used in the management of persistent allergic ASTHMA. Xolair

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