Literature DB >> 29208079

Asthma control, lung function, symptoms, and corticosteroid sparing after omalizumab initiation in patients with allergic asthma.

Dominic Pilon1, Abhishek Kavati2, Benjamin Ortiz2, Brandee Paknis2, Ashok Vegesna2, Bradd Schiffman3, Maryia Zhdanava1, Patrick Lefebvre1, Brian Stone3.   

Abstract

BACKGROUND: Omalizumab is approved in patients with moderate-to-severe allergic asthma with symptoms uncontrolled, despite the mainstay therapy.
OBJECTIVE: Electronic medical records (EMR) were used to increase the knowledge of omalizumab effectiveness in a real-world setting.
METHODS: Patients with uncontrolled moderate-to-severe allergic asthma, ages ≥12 years old, initiated on omalizumab (index date), with ≥12 months of pre- and postindex data, were identified in an EMR data base. An Asthma Control Test score (≥20 is considered well controlled), forced expiratory volume in 1 second as a percentage of the predicted value (<80% considered below normal), symptoms, and oral corticosteroid (OCS) and inhaled corticosteroid (ICS) use were compared in the 12-month post- versus the preindex period with univariate generalized estimating equations adjusted for repeated measurements.
RESULTS: A total of 208 patients (mean ± standard deviation[SD] age, 41 ± 19 years; 64.9% women; 71.2% white; and with a mean ± SD serum total immunoglobulin E level of 455.4 ± 644.7 IU/mL) were identified. In the post- versus preindex period, the patients were significantly more likely to have well-controlled asthma (odds ratio [OR] 1.72 [95% confidence interval {CI}, 1.11-2.64]) and less likely to have a lung function value below normal (nonsignificant) after omalizumab initiation. The patients experienced significantly less coughing (OR 0.66 [95% CI, 0.49-0.91]), shortness of breath (OR 0.60 [95% CI, 0.44-0.83]), and wheezing (OR 0.59 [95% CI, 0.43-0.81]), with no improvement in chest tightness. A significantly lower likelihood of new OCS prescriptions (OR 0.58 [95% CI, 0.41-0.82]) was observed. A lower likelihood of new high- and medium-dose ICS prescriptions was nonsignificant.
CONCLUSION: Omalizumab was associated with beneficial effects on asthma control and symptoms, and the likelihood of requiring new OCS prescriptions. An observed trend of improved lung function and lower likelihood of requiring high- and medium-dose ICS did not reach statistical significance.

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Year:  2017        PMID: 29208079     DOI: 10.2500/aap.2018.39.4111

Source DB:  PubMed          Journal:  Allergy Asthma Proc        ISSN: 1088-5412            Impact factor:   2.587


  5 in total

1.  Allergic diseases: A collection of interactive immunologic disorders at the crossroads of genetics, environment, and immunity.

Authors:  Joseph A Bellanti; Russell A Settipane
Journal:  Allergy Asthma Proc       Date:  2018-03-01       Impact factor: 2.587

2.  Efficacy of Shegan Mahuang Decoction for asthma: A systematic review and meta-analysis protocol.

Authors:  Yuhua Zhao; Xiaoping Pang
Journal:  Medicine (Baltimore)       Date:  2019-11       Impact factor: 1.817

3.  Oral corticosteroid-sparing effects of mepolizumab in severe eosinophilic asthma: evidence from randomized controlled trials and real-world studies.

Authors:  Thomas B Casale; Autumn Burnette; Arnaud Bourdin; Peter Howarth; Beth Hahn; Alexandra Stach-Klysh; Sandhya Khurana
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4.  Oral Corticosteroids Dependence and Biologic Drugs in Severe Asthma: Myths or Facts? A Systematic Review of Real-World Evidence.

Authors:  Luigino Calzetta; Marina Aiello; Annalisa Frizzelli; Giuseppina Bertorelli; Paola Rogliani; Alfredo Chetta
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Review 5.  Rational oral corticosteroid use in adult severe asthma: A narrative review.

Authors:  Li Ping Chung; John W Upham; Philip G Bardin; Mark Hew
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  5 in total

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