Li Jian-Xiong, Fan Li-Chao, Li Man-Hui, Cao Wei-Jun, Xu Jin-Fu
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Soochow University, Suzhou, China.
Respir Med. 2017 Jan;122:33-42. doi: 10.1016/j.rmed.2016.11.019. Epub 2016 Nov 26.
Omalizumab, a humanized mAb that binds to IgE, has been an effective therapy for patients with severe allergic asthma; however, there are few clinical trials examining the efficacy of Omalizumab in patients with allergic bronchopulmonary aspergillosis (ABPA) except some case reports. To assess the clinical and immunological effects of Omalizumab in ABPA patients, we made a synthesis review of 102 cases from 30 published literature, analyzed the effects of Omalizumab therapy in ABPA and conducted subgroup analyses to determine factors that influenced the therapy endpoints. We found that Omalizumab treatment not only provided a clinically important reduction in serum IgE, exacerbation rates and steroid requirement, but also showed attenuated asthma symptoms and improved pulmonary function parameters in patients with ABPA. Moreover, further discussion was made when interpretating the results. Double-blind, randomized, placebo-controlled trials are necessary to establish the efficacy and safety of this novel therapeutic intervention for ABPA patients.
奥马珠单抗是一种可与IgE结合的人源化单克隆抗体,对重症过敏性哮喘患者而言是一种有效的治疗药物;然而,除了一些病例报告外,几乎没有临床试验研究奥马珠单抗对变应性支气管肺曲霉病(ABPA)患者的疗效。为评估奥马珠单抗对ABPA患者的临床和免疫学影响,我们对30篇已发表文献中的102例病例进行了综合回顾,分析了奥马珠单抗治疗ABPA的效果,并进行亚组分析以确定影响治疗终点的因素。我们发现,奥马珠单抗治疗不仅在临床上显著降低了血清IgE、加重率和类固醇需求量,还减轻了ABPA患者的哮喘症状并改善了肺功能参数。此外,在解读结果时进行了进一步讨论。有必要开展双盲、随机、安慰剂对照试验,以确定这种新型治疗干预措施对ABPA患者的疗效和安全性。