Rubin A S, Souza-Machado A, Andradre-Lima M, Ferreira F, Honda A, Matozo T M
Chest Medicine, Health Science University, Porto Alegre, Brazil.
J Asthma. 2012 Apr;49(3):288-93. doi: 10.3109/02770903.2012.660297. Epub 2012 Feb 23.
To assess the impact of omalizumab as an add-on therapy to standard treatment with inhaled corticosteroids (ICS) and long-acting beta-2 agonists (LABA) on asthma-related quality of life (QoL) in patients with severe allergic asthma.
This was a 20-week, randomized, open-label, study involving Brazilian patients (>12 years) with severe persistent allergic asthma inadequately controlled despite regular treatment with, at least, ICS (≥500 μg/day fluticasone or equivalent) + LABA. The primary objective was to assess the mean change from baseline in overall Asthma-related Quality of Life Questionnaire (AQLQ) score in omalizumab-treated patients compared with the control group. Secondary outcome measures included rescue medication use, incidence of asthma exacerbations, perception of treatment efficacy among patients, mean change from baseline in AQLQ score, and >1.5-point increase in overall AQLQ score.
In the omalizumab group, overall AQLQ score was 3.2 (0.9) (mean [SD]) at baseline and 4.4 (1.3) at week 20 versus 3.0 (1.0) at baseline and 3.0 (1.1) at week 20 in the control group. Mean change from baseline on overall AQLQ score at week 20 in the omalizumab group was 1.2 (0.2) versus 0 (0.1) in the control group, showing a significant increase in scores from baseline in the omalizumab group (p < .001). There was also a statistically significant difference (p < .001) in the number of patients who showed a >1.5-point increase from baseline in overall AQLQ score after 20 weeks, thus indicating a better QoL in the omalizumab group. There was no significant difference with respect to the use of rescue medication, incidence of asthma exacerbation, and adverse events between treatment groups. The global evaluation of treatment effectiveness was significantly better for omalizumab (p < .001).
Omalizumab was well tolerated and significantly improved the overall AQLQ score. Hence, it is a potential add-on therapy for severe persistent allergic asthma not controlled by standard prescribed treatment in Brazilian patients.
评估奥马珠单抗作为吸入性糖皮质激素(ICS)和长效β2受体激动剂(LABA)标准治疗的附加疗法对重度过敏性哮喘患者哮喘相关生活质量(QoL)的影响。
这是一项为期20周的随机、开放标签研究,纳入了年龄大于12岁、患有重度持续性过敏性哮喘且尽管接受了至少ICS(≥500μg/天氟替卡松或等效药物)+LABA的常规治疗但病情仍控制不佳的巴西患者。主要目的是评估奥马珠单抗治疗组患者与对照组相比,哮喘相关生活质量问卷(AQLQ)总分从基线的平均变化。次要结局指标包括急救药物使用情况、哮喘加重的发生率、患者对治疗效果的感知、AQLQ总分从基线的平均变化以及AQLQ总分增加超过1.5分的情况。
奥马珠单抗组基线时AQLQ总分平均为3.2(0.9)(均值[标准差]),第20周时为4.4(1.3);而对照组基线时为3.0(1.0),第20周时为3.0(1.1)。奥马珠单抗组第20周时AQLQ总分相对于基线的平均变化为1.2(0.2),而对照组为0(0.1),表明奥马珠单抗组的分数相对于基线有显著增加(p<.001)。20周后AQLQ总分相对于基线增加超过1.5分的患者数量也存在统计学显著差异(p<.001),这表明奥马珠单抗组的生活质量更好。治疗组之间在急救药物使用、哮喘加重发生率和不良事件方面没有显著差异。奥马珠单抗的治疗效果总体评估明显更好(p<.001)。
奥马珠单抗耐受性良好,显著提高了AQLQ总分。因此,对于巴西患者中未通过标准处方治疗控制的重度持续性过敏性哮喘,它是一种潜在的附加疗法。