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奥马珠单抗治疗中重度哮喘患者的疗效与安全性:中国患者与高加索患者随机对照试验数据的分析比较

Efficacy and safety of omalizumab in patients with moderate-to-severe asthma: An analytic comparison of data from randomized controlled trials between Chinese and Caucasians.

作者信息

Li Jing, Yang Jing, Kong Lingfei, Huang Yijiang, Chen Ping, Yan Xixin, Liu Xiaoxia, Zho Xiangdongu, Liu Jinming, Zhu Xiaoli, Humphries Michael, Wang Linda, Pethe Abhijit, Wang Xinting, Kottakis Ioannis, Fogel Robert, Zhong Nanshan

机构信息

State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Novartis China Global Drug Development, China.

出版信息

Asian Pac J Allergy Immunol. 2022 Sep;40(3):223-231. doi: 10.12932/AP-260819-0630.

Abstract

BACKGROUND

Omalizumab has > 15 years of real-world evidence of effectiveness in Caucasian patients. In August 2017, it was approved as an add-on therapy for the management of moderate-to-severe asthma in China.

OBJECTIVE

To compare the efficacy and safety of omalizumab in Chinese and Caucasian patients.

METHODS

This analysis included clinical trial data from a Chinese study (NCT01202903) and four studies with predominantly Caucasian patients (008, 009, EXTRA and INNOVATE). The following outcomes were analyzed: change from baseline in morning peak expiratory flow (mPEF), percentage predicted forced expiratory volume in one second (FEV1), patient-reported outcomes (PROs), asthma exacerbation and safety. Further, a population pharmacokinetic/pharmacodynamic (PK/PD) was also assessed.

RESULTS

In the Chinese study, omalizumab significantly improved the mPEF from baseline vs placebo at Weeks > 4-8 through > 16-20; however, the change in mPEF did not reach statistical significance at Week 24. A similar trend towards improvement in mPEF was observed in the studies with Caucasians (INNOVATE, 008 and 009). In all studies, omalizumab showed greater improvement in %predicted FEV1, AQLQ score, and GETE score vs placebo. In addition, asthma symptom scores and seasonal exacerbations were lower, especially during winter, in the Chinese study, and was comparable to studies in Caucasians. PK/PD analyses showed that steady-state PK of omalizumab; free or total immunoglobulin E levels were similar in all studies.

CONCLUSIONS

The clinical efficacy and safety of omalizumab was comparable among Chinese and Caucasian patients with moderate-to-severe asthma supporting therapeutic effectiveness, irrespective of race, ethnicity and geographical factors.

摘要

背景

奥马珠单抗在高加索患者中已有超过15年的真实世界有效性证据。2017年8月,它在中国被批准作为中重度哮喘管理的附加疗法。

目的

比较奥马珠单抗在中国患者和高加索患者中的疗效和安全性。

方法

该分析纳入了一项中国研究(NCT01202903)以及四项主要针对高加索患者的研究(008、009、EXTRA和INNOVATE)的临床试验数据。分析了以下结果:晨间呼气峰流速(mPEF)较基线的变化、一秒用力呼气容积(FEV1)预测值百分比、患者报告结局(PROs)、哮喘急性发作和安全性。此外,还评估了群体药代动力学/药效学(PK/PD)。

结果

在中国研究中,奥马珠单抗在第4至8周及之后直至第16至20周时,与安慰剂相比显著改善了mPEF较基线的水平;然而,在第24周时mPEF的变化未达到统计学显著性。在高加索患者的研究(INNOVATE、008和009)中也观察到了类似的mPEF改善趋势。在所有研究中,与安慰剂相比,奥马珠单抗在FEV1预测值百分比、哮喘生活质量问卷(AQLQ)评分和全球哮喘治疗和经济评估(GETE)评分方面显示出更大的改善。此外,在中国研究中,哮喘症状评分和季节性急性发作较低,尤其是在冬季,且与高加索患者的研究相当。PK/PD分析表明,奥马珠单抗的稳态药代动力学;游离或总免疫球蛋白E水平在所有研究中相似。

结论

奥马珠单抗在中重度哮喘的中国患者和高加索患者中的临床疗效和安全性相当,支持其治疗有效性,不受种族、民族和地理因素影响。

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