Vignola A M, Humbert M, Bousquet J, Boulet L-P, Hedgecock S, Blogg M, Fox H, Surrey K
Institute of Internal Medicine Pneumology, University of Palermo, Palermo, Italy.
Allergy. 2004 Jul;59(7):709-17. doi: 10.1111/j.1398-9995.2004.00550.x.
Anti-IgE therapy could be particularly beneficial for patients with concomitant disease as it targets a common factor in both diseases. The aim of this study was to evaluate the efficacy and safety of omalizumab in patients with concomitant moderate-to-severe asthma and persistent allergic rhinitis.
This multicentre, randomized, double-blind, parallel-group, placebo-controlled trial evaluated the safety and efficacy of omalizumab. A total of 405 patients (12-74 years) with a stable treatment (>/= 400 microg budesonide Turbuhaler) and >/= 2 unscheduled medical visits for asthma during the past year or >/= 3 during the past 2 years were enrolled. Patients received omalizumab (>/= 0.016 mg/kg/IgE [IU/ml] per 4 weeks) or placebo for 28 weeks.
Fewer patients treated with omalizumab experienced asthma exacerbations (20.6%) than placebo-treated patients (30.1%), P = 0.02. A clinically significant (>/= 1.0 point) improvement in both Asthma Quality of Life Questionnaire and Rhinitis Quality of Life Questionnaire occurred in 57.7% of omalizumab patients compared with 40.6% of placebo patients (P < 0.001). Omalizumab reduced Wasserfallen symptom scores for asthma (P = 0.023), rhinitis (P < 0.001) and the composite asthma/rhinitis scores (P < 0.001) compared with placebo. Serious adverse events were observed in 1.4% of omalizumab-treated patients and 1.5% of placebo-treated patients.
Omalizumab is well tolerated and effective in preventing asthma exacerbations and improving quality of life in patients with concomitant asthma and persistent allergic rhinitis.
抗IgE疗法对合并疾病的患者可能特别有益,因为它针对两种疾病的共同因素。本研究的目的是评估奥马珠单抗在合并中重度哮喘和持续性过敏性鼻炎患者中的疗效和安全性。
这项多中心、随机、双盲、平行组、安慰剂对照试验评估了奥马珠单抗的安全性和疗效。共纳入405例年龄在12至74岁之间、接受稳定治疗(≥400微克布地奈德都保)且在过去一年中有≥2次因哮喘进行的非计划就诊或在过去两年中有≥3次此类就诊的患者。患者接受奥马珠单抗(每4周≥0.016毫克/千克/IgE[国际单位/毫升])或安慰剂治疗28周。
接受奥马珠单抗治疗的患者发生哮喘加重的比例(20.6%)低于接受安慰剂治疗的患者(30.1%),P = 0.02。奥马珠单抗治疗的患者中,57.7%的患者哮喘生活质量问卷和鼻炎生活质量问卷均有临床显著(≥1.0分)改善,而安慰剂治疗的患者中这一比例为40.6%(P < 0.001)。与安慰剂相比,奥马珠单抗降低了哮喘(P = 0.023)、鼻炎(P < 0.001)以及哮喘/鼻炎综合评分(P < 0.001)的Wasserfallen症状评分。在接受奥马珠单抗治疗的患者中,1.4%观察到严重不良事件,接受安慰剂治疗的患者中这一比例为1.5%。
奥马珠单抗耐受性良好,可有效预防合并哮喘和持续性过敏性鼻炎患者的哮喘加重并改善生活质量。