Omalizumab effectiveness in patients with severe allergic asthma according to blood eosinophil count: the STELLAIR study. 2018

Marc Humbert, and Camille Taillé, and Laurence Mala, and Vincent Le Gros, and Jocelyne Just, and Mathieu Molimard, and
Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.

Omalizumab is a monoclonal anti-IgE antibody used to treat severe allergic asthma (SAA). The aim of the STELLAIR study was to determine the importance of pre-treatment blood eosinophil count as a predictive measure for response to omalizumab.This retrospective real-life study was conducted in France between December 2015 and September 2016 using medical records of SAA omalizumab-treated patients. Response to omalizumab was assessed by three criteria: physician evaluation, reduction of ≥40% in annual exacerbation rate and a combination of both. Response rate was calculated according to blood eosinophil count measured in the year prior to omalizumab initiation.872 SAA omalizumab-treated patients were included by 78 physicians (723 adults (age ≥18 years) and 149 minors (age 6-17 years)). Blood eosinophil count was ≥300 cells·µL-1 in 52.1% of adults and 73.8% of minors. By physician evaluation, 67.2% of adults and 77.2% of minors were responders and 71.1% adults and 78.5% minors had a ≥40% reduction in the exacerbation rate. In adults, the response rate for combined criteria was 58.4% (95% CI 53.2-63.4%) for blood eosinophils ≥300 cells·µL-1 (n=377) and 58.1% (95% CI 52.7-63.4%) for blood eosinophils <300 cells·µL-1 (n=346).This study shows that a large proportion of patients with SAA have a blood eosinophil count ≥300 cells·µL-1, and suggests that omalizumab effectiveness is similar in "high" and "low" eosinophil subgroups.

UI MeSH Term Description Entries
D007073 Immunoglobulin E An immunoglobulin associated with MAST CELLS. Overexpression has been associated with allergic hypersensitivity (HYPERSENSITIVITY, IMMEDIATE). IgE
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
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
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
D005602 France A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris. Corsica,Saint Pierre and Miquelon,Miquelon and Saint Pierre,Miquelon and St. Pierre,St. Pierre and Miquelon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000067251 Symptom Flare Up A transient exacerbation of symptoms of an existing disease or condition. Acute Symptom Flare,Symptom Exacerbation,Symptom Exaggeration,Symptom Flare-up,Symptom Flareup,Symptom Flaring Up,Symptom Increase,Symptom Magnification,Symptom Worsening,Acute Symptom Flares,Exacerbation, Symptom,Exaggeration, Symptom,Flare Up, Symptom,Flare Ups, Symptom,Flare-up, Symptom,Flare-ups, Symptom,Flareup, Symptom,Flareups, Symptom,Flaring Up, Symptom,Increase, Symptom,Magnification, Symptom,Symptom Exacerbations,Symptom Exaggerations,Symptom Flare Ups,Symptom Flare, Acute,Symptom Flare-ups,Symptom Flareups,Symptom Magnifications,Worsening, Symptom
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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