Hutyrová Beáta, Bystroň Jaromír
Department of Allergology and Clinical Immunology, University Hospital Olomouc, Olomouc, Czech Republic.
Department of Immunology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic.
Postepy Dermatol Alergol. 2018 Oct;35(5):510-515. doi: 10.5114/ada.2018.77243. Epub 2018 Jul 19.
Omalizumab is indicated for the treatment of severe allergic asthma (SAA) and chronic spontaneous urticaria, although a number of studies have confirmed the effectiveness of this therapy also for other IgE-mediated diseases.
To assess the impact of anti-IgE therapy on SAA and comorbid IgE-mediated allergic diseases in patients treated with omalizumab for SAA enrolled in the CAR (Czech Anti-IgE Registry).
Three hundred and ten patients with SAA treated with omalizumab were enrolled in the CAR. Two hundred and twenty-nine individuals were evaluated after 12 months of omalizumab treatment for asthma control test (ACT), examination of fractional exhaled nitric oxide (FENO), forced expiratory volume in 1 s (FEV), the use of systemic corticosteroids, side effects of treatment and clinical effect of omalizumab on allergic comorbidities (allergic rhinitis, chronic urticaria, atopic dermatitis and food allergy).
After 12 months of treatment with omalizumab, patients experienced a significant improvement of ACT and FEV, reduction of FENO, use of systemic corticosteroids for asthma exacerbations and dose of maintenance oral corticosteroid therapy. The positive effect of treatment with omalizumab was observed in 82.2% of patients with allergic rhinitis, in 85.7% of patients with chronic urticaria, in 82.1% of patients with atopic dermatitis, and in 67.3% of patients with food allergy.
In the CAR registry, patients with SAA treated with omalizumab showed a significant positive effect of anti-IgE therapy not only on the asthma control, but also on allergic comorbidities.
奥马珠单抗被用于治疗重度过敏性哮喘(SAA)和慢性自发性荨麻疹,尽管多项研究已证实该疗法对其他IgE介导的疾病也有效。
评估抗IgE疗法对在CAR(捷克抗IgE注册中心)登记的接受奥马珠单抗治疗的SAA患者的SAA及合并的IgE介导的过敏性疾病的影响。
310例接受奥马珠单抗治疗的SAA患者被纳入CAR。在奥马珠单抗治疗12个月后,对229例患者进行了哮喘控制测试(ACT)、呼出一氧化氮分数(FENO)检测、1秒用力呼气容积(FEV)、全身用糖皮质激素的使用情况、治疗副作用以及奥马珠单抗对过敏性合并症(过敏性鼻炎、慢性荨麻疹、特应性皮炎和食物过敏)的临床疗效评估。
奥马珠单抗治疗12个月后,患者的ACT和FEV有显著改善,FENO降低,用于哮喘急性发作的全身用糖皮质激素及维持口服糖皮质激素治疗剂量减少。在82.2%的过敏性鼻炎患者、85.7%的慢性荨麻疹患者、82.1%的特应性皮炎患者和67.3%的食物过敏患者中观察到奥马珠单抗治疗的积极效果。
在CAR注册中心,接受奥马珠单抗治疗的SAA患者不仅在哮喘控制方面,而且在过敏性合并症方面均显示出抗IgE疗法的显著积极效果。