Thomson Neil C, Chaudhuri Rekha
Institute of Infection, Immunity, and Inflammation, University of Glasgow, and Respiratory Medicine, Gartnavel General Hospital, Glasgow G12 OYN, UK.
Clin Med Insights Circ Respir Pulm Med. 2012;6:27-40. doi: 10.4137/CCRPM.S7793. Epub 2012 Jun 12.
Omalizumab, a humanized monoclonal antibody that binds circulating IgE antibody, is a treatment option for patients with moderate to severe allergic asthma whose asthma is poorly controlled with inhaled corticosteroids and inhaled long-acting β(2) agonist bronchodilators. This review considers the mechanism of action, pharmacokinetics, efficacy, safety and place in management of omalizumab in asthma and focuses particularly on key articles published over the last three years. Omalizumab reduces IgE mediated airway inflammation and its effect on airway remodeling is under investigation. Recent long-term clinical trials confirm the benefits of omalizumab in reducing exacerbations and symptoms in adults and in children with moderate to severe allergic asthma. No clinical or immunological factor consistently predicts a good therapeutic response to omalizumab in allergic asthma. In responders, the duration of treatment is unclear. The main adverse effect of omalizumab is anaphylaxis, although this occurs infrequently. Preliminary data from a five-year safety study has raised concerns about increased cardiovascular events and a final report is awaited. Clinical trials are in progress to determine whether omalizumab has efficacy in the treatment of non-allergic asthma.
奥马珠单抗是一种能结合循环IgE抗体的人源化单克隆抗体，适用于中重度过敏性哮喘患者，这类患者使用吸入性糖皮质激素和吸入长效β2受体激动剂支气管扩张剂后哮喘控制不佳。本综述探讨了奥马珠单抗在哮喘治疗中的作用机制、药代动力学、疗效、安全性及地位，尤其关注过去三年发表的关键文章。奥马珠单抗可减轻IgE介导的气道炎症，其对气道重塑的影响正在研究中。近期的长期临床试验证实了奥马珠单抗在减少成人及中重度过敏性哮喘儿童病情加重和症状方面的益处。在过敏性哮喘中，没有临床或免疫学因素能始终预测对奥马珠单抗的良好治疗反应。对于有反应者，治疗持续时间尚不清楚。奥马珠单抗的主要不良反应是过敏反应，不过这种情况很少发生。一项为期五年的安全性研究的初步数据引发了对心血管事件增加的担忧，目前正在等待最终报告。正在进行临床试验以确定奥马珠单抗在治疗非过敏性哮喘方面是否有效。
