Lai Tianwen, Wang Shaobin, Xu Zhiwei, Zhang Chao, Zhao Yun, Hu Yue, Cao Chao, Ying Songmin, Chen Zhihua, Li Wen, Wu Bin, Shen Huahao
1] Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China [2] Department of Respiratory and Critical Care Medicine, Affiliated Hospital, Institute of Respiratory Diseases, Guangdong Medicine College, Zhanjiang, China.
Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
Sci Rep. 2015 Feb 3;5:8191. doi: 10.1038/srep08191.
Currently, limited information is available to clinicians regarding the long-term efficacy of omalizumab treatment for allergic asthma. In this report, we aimed to (i) systematically review the evidence regarding the long-term efficacy of omalizumab in patients with persistent uncontrolled allergic asthma, and to (ii) discuss the cost-effectiveness evidence published for omalizumab in this patient population. A comprehensive search for randomized controlled trials (RCTs; ≥52 weeks) was performed, and six studies met our final inclusion criteria (n = 2,749). Omalizumab was associated with significant improvements in quality of life and the Global Evaluation of Treatment Effectiveness. Omalizumab also allowed patients to completely withdraw from inhaled corticosteroid therapy and did not increase the overall incidence of adverse events. However, there was insufficient evidence that omalizumab reduced the incidence of exacerbations, and the cost-effectiveness of omalizumab varied across studies. Our data indicated that omalizumab use for at least 52 weeks in patients with persistent uncontrolled allergic asthma was accompanied by an acceptable safety profile, but it lacked effect on the asthma exacerbations. Use of omalizumab was associated with a higher cost than conventional therapy, but these increases may be cost-effective if the medication is used in patients with severe allergic asthma.
目前，临床医生可获得的关于奥马珠单抗治疗过敏性哮喘长期疗效的信息有限。在本报告中，我们旨在：（i）系统回顾关于奥马珠单抗治疗持续性未控制过敏性哮喘患者长期疗效的证据，以及（ii）讨论针对该患者群体已发表的奥马珠单抗成本效益证据。我们全面检索了随机对照试验（RCT；≥52周），有六项研究符合我们的最终纳入标准（n = 2,749）。奥马珠单抗与生活质量和治疗效果总体评估的显著改善相关。奥马珠单抗还使患者能够完全停用吸入性糖皮质激素治疗，且未增加不良事件的总体发生率。然而，没有足够的证据表明奥马珠单抗降低了哮喘发作的发生率，并且奥马珠单抗的成本效益在不同研究中有所不同。我们的数据表明，在持续性未控制过敏性哮喘患者中使用奥马珠单抗至少52周，其安全性是可接受的，但对哮喘发作没有影响。使用奥马珠单抗的成本高于传统疗法，但如果将该药物用于重度过敏性哮喘患者，这些成本增加可能具有成本效益。
