Département de Pharmacologie, CHU Pellegrin-Carreire, de Bordeaux - Université Victor Segalen, Bordeaux, France.
Respir Med. 2010 Sep;104(9):1381-5. doi: 10.1016/j.rmed.2010.06.001.
Long-term oral corticosteroid (OCS) therapy is associated with significant burden on patients and healthcare resources; treatments that may help reduce their use are important to improve asthma management.
French and German clinicians prescribing omalizumab for >16 weeks to patients with severe persistent allergic asthma collected OCS use data. OCS use was recorded at baseline and at a non-specific time point beyond 16 weeks from initiation of omalizumab. The number of asthma exacerbations (FEV(1) < 60% of personal best, requiring OCS burst and unscheduled doctor/emergency visit or hospitalization) and asthma-related hospitalizations during the 12-months prior to omalizumab treatment and during the observation period were also recorded.
Overall, 346 patients were treated with omalizumab for >16 weeks. Of these, 166 (48.0%) were receiving maintenance OCS (France, n = 64; Germany, n = 102). Following omalizumab therapy, 84 (50.6%) patients on OCS at baseline reduced/stopped OCS dose at the time of data collection; 34 (20.5%) stopped and 50 (30.1%) reduced OCS. In all patients receiving maintenance OCS at baseline, mean reduction from baseline in daily OCS dose was 29.6% (7.1 mg prednisolone). In patients who reduced/stopped maintenance OCS, mean reduction from baseline in daily OCS dose was 74.3% (15.4 mg prednisolone). Reductions in exacerbations and hospitalizations were observed from the 12-months prior to baseline in patients at the time of data collection, irrespective of change in OCS dose.
European real-life experience demonstrates the OCS-sparing potential of omalizumab in some patients with severe allergic (IgE-mediated) asthma.
长期口服皮质类固醇(OCS)治疗会给患者和医疗资源带来很大负担;寻找可能有助于减少 OCS 用量的治疗方法对于改善哮喘管理非常重要。
为患有重度持续性过敏性哮喘且 OCS 治疗时间>16 周的法国和德国临床医生开具奥马珠单抗处方,收集 OCS 使用数据。OCS 使用数据记录于基线和奥马珠单抗治疗开始后>16 周的非特定时间点。在奥马珠单抗治疗前 12 个月和观察期间,还记录了哮喘加重(FEV1<个人最佳值的 60%,需要 OCS 冲击治疗和非计划就诊/急诊或住院)和哮喘相关住院的次数。
总体而言,有 346 例患者接受奥马珠单抗治疗>16 周。其中,166 例(48.0%)正在接受维持性 OCS 治疗(法国 64 例,德国 102 例)。在基线时接受 OCS 治疗的 84 例患者(50.6%)在数据收集时减少/停止了 OCS 剂量;34 例(20.5%)停止使用,50 例(30.1%)减少了 OCS 剂量。在所有基线时接受维持性 OCS 治疗的患者中,每日 OCS 剂量从基线的平均减少量为 29.6%(7.1 mg 泼尼松龙)。在减少/停止维持性 OCS 的患者中,每日 OCS 剂量从基线的平均减少量为 74.3%(15.4 mg 泼尼松龙)。在数据收集时接受治疗的患者,在基线前 12 个月观察到哮喘加重和住院的次数减少,而与 OCS 剂量的变化无关。
欧洲真实世界的经验表明,奥马珠单抗在一些重度过敏性(IgE 介导)哮喘患者中具有减少 OCS 用量的潜力。