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奥马珠单抗治疗中重度持续性哮喘亚洲人群的疗效和安全性。

Efficacy and safety of omalizumab in an Asian population with moderate-to-severe persistent asthma.

机构信息

Division of Respiratory Medicine, Department of Medicine, Teikyo University School of Medicine, Tokyo 173-8605, Japan.

出版信息

Respirology. 2009 Nov;14(8):1156-65. doi: 10.1111/j.1440-1843.2009.01633.x.

Abstract

BACKGROUND AND OBJECTIVE

The efficacy and safety of the anti-IgE antibody, omalizumab, has been widely studied in patients with asthma. However to date, no large studies have been performed in Asian populations. The aim of this study was to compare the efficacy and safety of omalizumab with placebo, as add-on therapy in Asian patients with moderate-to-severe persistent asthma.

METHODS

Japanese patients (20-75 years of age) with uncontrolled asthma, despite receiving high-dose inhaled corticosteroids and other standard therapies, were randomized to receive add-on treatment with omalizumab or placebo in a 16-week, double-blind, parallel-group, multicentre study.

RESULTS

Altogether, 315 treated patients were included in the efficacy and safety analyses. The change from baseline in morning PEF was 15.45 L/min (least squares mean) with omalizumab versus 2.25 L/min with placebo, a statistically significant difference of 13.19 L/min (P = 0.0004). Clinically significant asthma exacerbations occurred in six patients (4.0%) treated with omalizumab and in 18 patients (11.0%) treated with placebo. The odds ratio for the risk of experiencing an asthma exacerbation was 0.32 in favour of omalizumab (P = 0.0192). Changes in asthma symptom scores, daily life activity scores, sleep scores and rescue medication use were in favour of omalizumab, but group differences did not reach statistical significance. Adverse event rates were similar between omalizumab and placebo, except for injection site reactions, which were more frequently observed in the omalizumab group.

CONCLUSIONS

Add-on treatment with omalizumab improved asthma control without significant adverse events in Japanese patients with moderate-to-severe persistent asthma.

摘要

背景与目的

抗 IgE 抗体奥马珠单抗在哮喘患者中的疗效和安全性已得到广泛研究。然而,迄今为止,尚未在亚洲人群中进行过大型研究。本研究旨在比较奥马珠单抗与安慰剂作为附加疗法在亚洲中重度持续性哮喘患者中的疗效和安全性。

方法

未得到控制的哮喘日本患者(20-75 岁),尽管接受了高剂量吸入皮质激素和其他标准治疗,但在一项为期 16 周、双盲、平行组、多中心研究中被随机分配接受奥马珠单抗或安慰剂的附加治疗。

结果

共有 315 名接受治疗的患者纳入疗效和安全性分析。奥马珠单抗组的清晨 PEF 自基线的变化为 15.45 L/min(最小二乘均值),而安慰剂组为 2.25 L/min,差异具有统计学意义 13.19 L/min(P = 0.0004)。奥马珠单抗组有 6 名(4.0%)患者和安慰剂组有 18 名(11.0%)患者发生临床显著的哮喘加重。奥马珠单抗组发生哮喘加重的风险比为 0.32(P = 0.0192)。哮喘症状评分、日常生活活动评分、睡眠评分和急救药物使用的变化均有利于奥马珠单抗,但组间差异无统计学意义。奥马珠单抗组和安慰剂组的不良反应发生率相似,但奥马珠单抗组更常出现注射部位反应。

结论

奥马珠单抗附加治疗可改善日本中重度持续性哮喘患者的哮喘控制,且无明显不良反应。

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