Walters E Haydn, Walters Julia Ae, Wood-Baker Richard
University of Tasmania, Tasmania, Australia.
Expert Opin Pharmacother. 2007 Apr;8(5):585-92. doi: 10.1517/14656566.8.5.585.
In this narrative review the scientific rationale for the development of a therapeutic modality for asthma based on decreasing the circulating and cell-bound levels of immunoglobulin-E (IgE) is outlined. The one drug that has so far entered clinical practice to do this is a humanised monoclonal antibody to the Fc portion of the IgE molecule, omalizumab. It is highly effective in reducing IgE blood levels and its established mode of delivery is by subcutaneous injection. The clinical trial development of omalizumab is reviewed and the published data and claims for its efficacy and role in clinical practice is critically appraised. The target group of omalizumab has become focused on severe asthmatics who are still symptomatic after being administered with high-dose inhaled corticosteroids plus long-acting beta-agonists. The strongest evidence for effect is in those with frequent severe exacerbations.
在这篇叙述性综述中，概述了基于降低循环中和细胞结合的免疫球蛋白E（IgE）水平来开发哮喘治疗方法的科学依据。迄今为止，进入临床实践以实现这一目标的一种药物是针对IgE分子Fc部分的人源化单克隆抗体——奥马珠单抗。它在降低血液中IgE水平方面非常有效，其既定的给药方式是皮下注射。对奥马珠单抗的临床试验进展进行了综述，并对已发表的数据及其在临床实践中的疗效和作用声明进行了批判性评估。奥马珠单抗的目标人群已聚焦于在接受高剂量吸入性糖皮质激素加长效β受体激动剂治疗后仍有症状的重度哮喘患者。其疗效的最有力证据存在于频繁发生严重加重的患者中。
