Makoto Hoshino1, Junichi Ohtawa. 1. Department of Respiratory Medicine, Atami Hospital, International University of Health and Welfare, Atami, Japan. hoshino@iuhw.ac.jp
Abstract
BACKGROUND:Omalizumab may inhibit allergic inflammation and could contribute to decreasing airway remodeling in patients with asthma. OBJECTIVE: The aim of this study was to assess the effects of omalizumab on airway wall thickness using computed tomography (CT). METHODS:Thirty patients with severe persistent asthma were randomized to conventional therapy with (n = 14) or without omalizumab (n = 16) for 16 weeks. The following airway dimensions were assessed by a validated CT technique: airway wall area corrected for body surface area (WA/BSA), percentage wall area (WA%), wall thickness (T)/√BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus. The percentage of eosinophils in induced sputum, pulmonary function and the Asthma Quality of Life Questionnaire (AQLQ) were assessed as well. RESULTS: Treatment with omalizumab significantly decreased WA/BSA (p < 0.01), WA% (p < 0.01), and T/√BSA (p < 0.01), and increased Ai/BSA (p < 0.05), whereas conventional therapy resulted in no change. In the omalizumab group (n = 14), a significant decrease in the percentage of sputum eosinophils (p < 0.01), improved forced expiratory volume in 1 s (FEV(1)), and an improved AQLQ score were recorded. The changes in FEV(1)% predicted and sputum eosinophils were significantly correlated with changes in WA% (r = 0.88, p < 0.001, and r = 072, p < 0.01, respectively). CONCLUSIONS: These findings suggest that omalizumab reduced airway wall thickness and airway inflammation. Larger patient studies with longer-term follow-up are needed to show whether omalizumab can truly maintain improved airway wall dimensions.
RCT Entities:
BACKGROUND:Omalizumab may inhibit allergic inflammation and could contribute to decreasing airway remodeling in patients with asthma. OBJECTIVE: The aim of this study was to assess the effects of omalizumab on airway wall thickness using computed tomography (CT). METHODS: Thirty patients with severe persistent asthma were randomized to conventional therapy with (n = 14) or without omalizumab (n = 16) for 16 weeks. The following airway dimensions were assessed by a validated CT technique: airway wall area corrected for body surface area (WA/BSA), percentage wall area (WA%), wall thickness (T)/√BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus. The percentage of eosinophils in induced sputum, pulmonary function and the Asthma Quality of Life Questionnaire (AQLQ) were assessed as well. RESULTS: Treatment with omalizumab significantly decreased WA/BSA (p < 0.01), WA% (p < 0.01), and T/√BSA (p < 0.01), and increased Ai/BSA (p < 0.05), whereas conventional therapy resulted in no change. In the omalizumab group (n = 14), a significant decrease in the percentage of sputum eosinophils (p < 0.01), improved forced expiratory volume in 1 s (FEV(1)), and an improved AQLQ score were recorded. The changes in FEV(1)% predicted and sputum eosinophils were significantly correlated with changes in WA% (r = 0.88, p < 0.001, and r = 072, p < 0.01, respectively). CONCLUSIONS: These findings suggest that omalizumab reduced airway wall thickness and airway inflammation. Larger patient studies with longer-term follow-up are needed to show whether omalizumab can truly maintain improved airway wall dimensions.
Authors: Sumit Gupta; Ruth Hartley; Amisha Singapuri; Beverly Hargadon; William Monteiro; Ian D Pavord; Ana R Sousa; Richard P Marshall; Deepak Subramanian; David Parr; James J Entwisle; Salman Siddiqui; Vimal Raj; Christopher E Brightling Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: Brian D Moore; Dallas Hyde; Lisa Miller; Emily Wong; Jessica Frelinger; Edward S Schelegle Journal: Respiration Date: 2012-04-13 Impact factor: 3.580