International University of Health and Welfare, Sanno Hospital, Tokyo, Japan.
Novartis Pharma K.K., Tokyo, Japan.
Respir Med. 2018 Aug;141:56-63. doi: 10.1016/j.rmed.2018.06.021. Epub 2018 Jun 28.
Omalizumab (anti-IgE monoclonal antibody) is an approved add-on therapy for Japanese patients with severe allergic asthma. As directed by the Ministry of Health, Labor and Welfare Japan, a post-marketing surveillance (PMS) study on omalizumab was conducted between 2009 and 2017.
The PMS observed safety and efficacy of omalizumab in patients treated with open-label omalizumab for 52 weeks (with optional 2-year extension period). Primary safety outcomes included incidence and severity of adverse events (AEs) and adverse drug reactions (ADRs). Primary efficacy outcomes included physician-assessed global evaluation of treatment effectiveness (GETE). Asthma-exacerbation-related events including requirement for additional systemic steroid therapy, hospitalization, emergency room visits, unscheduled doctor visits, and absenteeism were also evaluated.
Of 3893 patients registered, 3620 (age [mean ± SD] 59.3 ± 16.11 years) were evaluated for 52 weeks; 44.12% were aged ≥65 years and 64.45% were women. Overall, 32.24% reported AEs and 15.30% reported serious AEs. ADRs were seen in 292 (8.07%) patients. GETE results showed that the majority of patients experienced clinical improvements (58.29% at 16 weeks and 62.40% at 52 weeks). Nearly half of all patients (47.96%) were free from asthma exacerbations after therapy. Omalizumab also reduced all events related to asthma exacerbations. No specific ADRs were observed in the elderly population.
This post-marketing study confirmed the clinically meaningful benefits of omalizumab in a majority of patients from Japan, and showed safety and efficacy in a real-life clinical setting to be consistent with previous reports.
奥马珠单抗(抗 IgE 单克隆抗体)是日本严重过敏性哮喘患者的一种已批准的附加疗法。按照日本厚生劳动省的指示,2009 年至 2017 年期间进行了奥马珠单抗的上市后监测(PMS)研究。
PMS 观察了接受开放标签奥马珠单抗治疗 52 周(可选 2 年延长期)的患者的奥马珠单抗的安全性和疗效。主要安全性结局包括不良事件(AE)和药物不良反应(ADR)的发生率和严重程度。主要疗效结局包括医生评估的治疗效果综合评估(GETE)。还评估了与哮喘加重相关的事件,包括需要额外全身皮质类固醇治疗、住院、急诊就诊、非计划性就诊和缺勤。
在注册的 3893 名患者中,3620 名(年龄[平均值±标准差]59.3±16.11 岁)接受了 52 周的评估;44.12%的患者年龄≥65 岁,64.45%为女性。总体而言,32.24%的患者报告了 AE,15.30%报告了严重 AE。292(8.07%)名患者出现了 ADR。GETE 结果表明,大多数患者的临床状况有所改善(16 周时为 58.29%,52 周时为 62.40%)。治疗后近一半的患者(47.96%)无哮喘加重。奥马珠单抗还减少了与哮喘加重相关的所有事件。在老年人群中未观察到特定的 ADR。
这项上市后研究证实了奥马珠单抗在日本大多数患者中具有显著的临床获益,并在真实临床环境中显示了安全性和疗效与既往报告一致。