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奥马珠单抗治疗成人严重变应性哮喘的“真实世界”疗效:一项荟萃分析。

'Real-world' effectiveness of omalizumab in adults with severe allergic asthma: a meta-analysis.

机构信息

Connell School of Nursing, Boston College William F, Chestnut Hill, MA, USA.

School of Nursing, Stony Brook University, Stony Brook, NY, USA.

出版信息

Expert Rev Clin Immunol. 2021 Jan;17(1):73-83. doi: 10.1080/1744666X.2020.1856658. Epub 2020 Dec 14.

DOI:10.1080/1744666X.2020.1856658
PMID:33307892
Abstract

Severe asthma affects 5-10% of the 350 million people with asthma worldwide. Findings from the authors' previous meta-analysis supported omalizumab use as an adjuvant treatment for severe allergic asthma. The publication of fourteen new articles necessitates an update of the meta-analysis. To evaluate the 'real-world' effectiveness of omalizumab in the treatment of acute allergic asthma in adults by calculating pooled effects estimates from data in published articles. Articles on omalizumab effectiveness in 'real-world' settings were identified. Effect sizes, including point estimates of the proportion of patients who met a given criteria, mean improvements relative to baseline, and change in the proportion of patients requiring oral corticosteroids compared to baseline were extracted. Meta-analysis of proportions was conducted to pool effect sizes based on proportions. Standardized mean differences (Hedges' g) were calculated from means and standard deviations. Relative risk was calculated from changes in proportions. Variability within and between studies was evaluated. Omalizumab increases the percentage of individuals rated 'good' or 'excellent' on the Global Evaluation of Treatment Effectiveness Scale. Omalizumab also improves respiratory function, quality-of-life, and asthma control while reducing medication usage, exacerbations, hospitalizations, and adverse events. 'Real-world' evidence continues to support the use of omalizumab as adjuvant treatment for severe allergic asthma.

摘要

严重哮喘影响着全球 3.5 亿哮喘患者中的 5-10%。作者之前的荟萃分析结果支持奥马珠单抗作为严重过敏性哮喘的辅助治疗。随着 14 篇新文章的发表,需要对该荟萃分析进行更新。通过计算发表文章中的数据的汇总效果估计值,评估奥马珠单抗在成人急性过敏性哮喘治疗中的“真实世界”有效性。确定了奥马珠单抗在“真实世界”环境中有效性的文章。提取了效果大小,包括符合给定标准的患者比例的点估计值、与基线相比的平均改善值,以及与基线相比需要口服皮质类固醇的患者比例的变化。根据比例对比例进行荟萃分析以汇总效果大小。从平均值和标准差计算标准化均数差异(Hedges'g)。从比例变化计算相对风险。评估了研究内和研究间的变异性。奥马珠单抗增加了在全球治疗效果评估量表上被评为“良好”或“优秀”的个体的百分比。奥马珠单抗还改善了呼吸功能、生活质量和哮喘控制,同时减少了药物使用、恶化、住院和不良反应。“真实世界”证据继续支持奥马珠单抗作为严重过敏性哮喘的辅助治疗。

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