William J Sheehan1, Rebecca Z Krouse2, Agustin Calatroni2, Peter J Gergen3, James E Gern4, Michelle A Gill5, Rebecca S Gruchalla5, Gurjit K Khurana Hershey6, Meyer Kattan7, Carolyn M Kercsmar6, Carin I Lamm7, Frederic F Little8, Melanie M Makhija9, Daniel A Searing10, Edward Zoratti11, William W Busse4, Stephen J Teach12. 1. Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: wsheehan@childrensnational.org. 2. Rho Federal Systems Division, Chapel Hill, NC. 3. National Institute of Allergy and Infectious Diseases, Rockville, Md. 4. University of Wisconsin School of Medicine and Public Health, Madison, Wis. 5. University of Texas Southwestern Medical Center, Dallas, Tex. 6. Cincinnati Children's Hospital, Cincinnati, Ohio. 7. College of Physicians and Surgeons, Columbia University, New York, NY. 8. Boston University School of Medicine, Boston, Mass. 9. Lurie Children's Hospital and Northwestern University School of Medicine, Chicago, Ill. 10. Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo. 11. Henry Ford Health System and Wayne State University School of Medicine, Detroit, Mich. 12. Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC.
Abstract
BACKGROUND: Perennial aeroallergen sensitization is associated with greater asthma morbidity and is required for treatment with omalizumab. OBJECTIVE: To investigate the predictive relationship between the number of aeroallergen sensitizations, total serum IgE, and serum eosinophil count, and response to omalizumab in children and adolescents with asthma treated during the fall season. METHODS: This analysis includes inner-city patients with persistent asthma and recent exacerbations aged 6-20 years comprising the placebo- and omalizumab-treated groups in 2 completed randomized clinical trials, the Inner-City Anti-IgE Therapy for Asthma study and the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations study. Logistic regression modeled the relationship between greater degrees of markers of allergic inflammation and the primary outcome of fall season asthma exacerbations. RESULTS: The analysis included 761 participants who were 62% male and 59% African American with a median age of 10 years. Fall asthma exacerbations were significantly higher in children with greater numbers of aeroallergen-specific sensitizations in the placebo group (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11-1.60; P < .01), but not in the omalizumab-treated children (OR, 1.08; 95% CI, 0.91-1.28; P = .37), indicating a significant differential effect (P < .01). Likewise, there was a differential effect of omalizumab treatment in children with greater baseline total serum IgE levels (P < .01) or greater baseline serum eosinophil counts (P < .01). Multiple aeroallergen sensitization was the best predictor of response to omalizumab; treated participants sensitized to ≥4 different groups of aeroallergens had a 51% reduction in the odds of a fall exacerbation (OR, 0.49; 95% CI, 0.30-0.81; P < .01). CONCLUSIONS: In preventing fall season asthma exacerbations, treatment with omalizumab was most beneficial in children with a greater degree of allergic inflammation.
BACKGROUND: Perennial aeroallergen sensitization is associated with greater asthma morbidity and is required for treatment with omalizumab. OBJECTIVE: To investigate the predictive relationship between the number of aeroallergen sensitizations, total serum IgE, and serum eosinophil count, and response to omalizumab in children and adolescents with asthma treated during the fall season. METHODS: This analysis includes inner-city patients with persistent asthma and recent exacerbations aged 6-20 years comprising the placebo- and omalizumab-treated groups in 2 completed randomized clinical trials, the Inner-City Anti-IgE Therapy for Asthma study and the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations study. Logistic regression modeled the relationship between greater degrees of markers of allergic inflammation and the primary outcome of fall season asthma exacerbations. RESULTS: The analysis included 761 participants who were 62% male and 59% African American with a median age of 10 years. Fall asthma exacerbations were significantly higher in children with greater numbers of aeroallergen-specific sensitizations in the placebo group (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11-1.60; P < .01), but not in the omalizumab-treated children (OR, 1.08; 95% CI, 0.91-1.28; P = .37), indicating a significant differential effect (P < .01). Likewise, there was a differential effect of omalizumab treatment in children with greater baseline total serum IgE levels (P < .01) or greater baseline serum eosinophil counts (P < .01). Multiple aeroallergen sensitization was the best predictor of response to omalizumab; treated participants sensitized to ≥4 different groups of aeroallergens had a 51% reduction in the odds of a fall exacerbation (OR, 0.49; 95% CI, 0.30-0.81; P < .01). CONCLUSIONS: In preventing fall season asthma exacerbations, treatment with omalizumab was most beneficial in children with a greater degree of allergic inflammation.
Authors: Christine A Sorkness; Jeremy J Wildfire; Agustin Calatroni; Herman E Mitchell; William W Busse; George T O'Connor; Jacqueline A Pongracic; Kristie Ross; Michelle A Gill; Meyer Kattan; Wayne J Morgan; Stephen J Teach; Peter J Gergen; Andrew H Liu; Stanley J Szefler Journal: J Allergy Clin Immunol Pract Date: 2013-02-26
Authors: Stephen J Teach; Michelle A Gill; Alkis Togias; Christine A Sorkness; Samuel J Arbes; Agustin Calatroni; Jeremy J Wildfire; Peter J Gergen; Robyn T Cohen; Jacqueline A Pongracic; Carolyn M Kercsmar; Gurjit K Khurana Hershey; Rebecca S Gruchalla; Andrew H Liu; Edward M Zoratti; Meyer Kattan; Kristine A Grindle; James E Gern; William W Busse; Stanley J Szefler Journal: J Allergy Clin Immunol Date: 2015-10-27 Impact factor: 10.793
Authors: J Bousquet; K Rabe; M Humbert; K F Chung; W Berger; H Fox; G Ayre; H Chen; K Thomas; M Blogg; S Holgate Journal: Respir Med Date: 2007-03-06 Impact factor: 3.415