Sheehan William J, Krouse Rebecca Z, Calatroni Agustin, Gergen Peter J, Gern James E, Gill Michelle A, Gruchalla Rebecca S, Khurana Hershey Gurjit K, Kattan Meyer, Kercsmar Carolyn M, Lamm Carin I, Little Frederic F, Makhija Melanie M, Searing Daniel A, Zoratti Edward, Busse William W, Teach Stephen J
Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC.
Rho Federal Systems Division, Chapel Hill, NC.
J Allergy Clin Immunol Pract. 2020 Oct;8(9):3021-3028.e2. doi: 10.1016/j.jaip.2020.03.051. Epub 2020 May 4.
Perennial aeroallergen sensitization is associated with greater asthma morbidity and is required for treatment with omalizumab.
To investigate the predictive relationship between the number of aeroallergen sensitizations, total serum IgE, and serum eosinophil count, and response to omalizumab in children and adolescents with asthma treated during the fall season.
This analysis includes inner-city patients with persistent asthma and recent exacerbations aged 6-20 years comprising the placebo- and omalizumab-treated groups in 2 completed randomized clinical trials, the Inner-City Anti-IgE Therapy for Asthma study and the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations study. Logistic regression modeled the relationship between greater degrees of markers of allergic inflammation and the primary outcome of fall season asthma exacerbations.
The analysis included 761 participants who were 62% male and 59% African American with a median age of 10 years. Fall asthma exacerbations were significantly higher in children with greater numbers of aeroallergen-specific sensitizations in the placebo group (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11-1.60; P < .01), but not in the omalizumab-treated children (OR, 1.08; 95% CI, 0.91-1.28; P = .37), indicating a significant differential effect (P < .01). Likewise, there was a differential effect of omalizumab treatment in children with greater baseline total serum IgE levels (P < .01) or greater baseline serum eosinophil counts (P < .01). Multiple aeroallergen sensitization was the best predictor of response to omalizumab; treated participants sensitized to ≥4 different groups of aeroallergens had a 51% reduction in the odds of a fall exacerbation (OR, 0.49; 95% CI, 0.30-0.81; P < .01).
In preventing fall season asthma exacerbations, treatment with omalizumab was most beneficial in children with a greater degree of allergic inflammation.
常年性气传变应原致敏与更高的哮喘发病率相关，且是使用奥马珠单抗治疗的必要条件。
探讨气传变应原致敏数量、血清总IgE和血清嗜酸性粒细胞计数之间的预测关系，以及秋季治疗期间哮喘儿童和青少年对奥马珠单抗的反应。
该分析纳入了年龄在6至20岁、患有持续性哮喘且近期病情加重的市中心患者，这些患者来自两项已完成的随机临床试验中的安慰剂组和奥马珠单抗治疗组，即市中心哮喘抗IgE治疗研究和秋季加重期预防性奥马珠单抗或逐步升级治疗研究。逻辑回归模型分析了过敏炎症指标程度与秋季哮喘加重这一主要结局之间的关系。
分析纳入了761名参与者，其中男性占62%，非裔美国人占59%，中位年龄为10岁。在安慰剂组中，气传变应原特异性致敏数量较多的儿童秋季哮喘加重情况显著更高（优势比[OR]，1.33；9
