Long Aidan A, Fish James E, Rahmaoui Abdelkader, Miller Mary K, Bradley Mary S, Taki Hassan N, Demeo Anthony N, Tilles Stephen A, Szefler Stanley J
Massachusetts General Hospital, Division of Rheumatology, Allergy and Immunology, Boston, Massachusetts, USA.
Ann Allergy Asthma Immunol. 2009 Sep;103(3):212-9. doi: 10.1016/S1081-1206(10)60184-6.
The Epidemiologic Study of Xolair (omalizumab): Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma (EXCELS) is a unique opportunity to evaluate the prospective, long-term clinical safety and effectiveness of the anti-IgE antibody omalizumab (Xolair) in real-world clinical practice.
To describe the study design and study cohorts of EXCELS at baseline and to compare the characteristics of this population with other large asthma cohorts.
Patients with moderate-to-severe persistent asthma and a positive skin test result or in vitro reactivity to a perennial aeroallergen were eligible for EXCELS. Two cohorts of patients with asthma were enrolled: those treated with omalizumab and those not treated with omalizumab. We analyzed baseline demographic and clinical characteristics, including asthma history and control and allergy history.
Large proportions of patients enrolled in EXCELS had historically severe and poorly or not well-controlled asthma at the time of enrollment, objective evidence of airway obstruction, a history of long-term oral corticosteroid use, and/or other allergic disorders. Minor differences were observed between the omalizumab and nonomalizumab cohorts. Our total patient cohort was generally similar to other large cohorts. In a subgroup analysis, patients who had received omalizumab within 7 days before enrollment had more severe asthma and greater degrees of impairment at baseline than nonomalizumab patients.
This study of baseline characteristics in EXCELS offers a unique opportunity to better understand the history of allergic patients with moderate-to-severe asthma in a real-world treatment setting. This analysis of EXCELS baseline data sets the foundation for long-term assessment of the safety and effectiveness of omalizumab.
Xolair(奥马珠单抗)的流行病学研究:评估中重度哮喘患者的临床疗效和长期安全性(EXCELS)是一个独特的机会,可在真实临床实践中评估抗IgE抗体奥马珠单抗(Xolair)的前瞻性长期临床安全性和有效性。
描述EXCELS研究在基线时的研究设计和研究队列,并将该人群的特征与其他大型哮喘队列进行比较。
中重度持续性哮喘患者且皮肤试验结果阳性或对常年性气传变应原体外反应阳性者符合EXCELS入选标准。纳入了两组哮喘患者:接受奥马珠单抗治疗的患者和未接受奥马珠单抗治疗的患者。我们分析了基线人口统计学和临床特征,包括哮喘病史、控制情况和过敏史。
EXCELS研究中很大比例的患者在入组时既往有严重且哮喘控制不佳或未得到良好控制的情况、存在气道阻塞的客观证据、有长期口服糖皮质激素使用史和/或其他过敏性疾病。奥马珠单抗组和非奥马珠单抗组之间观察到微小差异。我们的总体患者队列与其他大型队列总体相似。在亚组分析中,入组前7天内接受过奥马珠单抗治疗的患者在基线时哮喘更严重,功能损害程度比未接受奥马珠单抗治疗的患者更大。
这项关于EXCELS基线特征的研究提供了一个独特的机会,以更好地了解真实治疗环境中中重度哮喘过敏患者的病史。对EXCELS基线数据的分析为长期评估奥马珠单抗的安全性和有效性奠定了基础。