Huang Wei-Chang, Fu Pin-Kuei, Chan Ming-Cheng, Chin Chun-Shih, Huang Wen-Nan, Lai Kuo-Lung, Wang Jiun-Long, Hung Wei-Ting, Wu Yi-Da, Hsieh Chia-Wei, Wu Ming-Feng, Chen Yi-Hsing, Hsu Jeng-Yuan
Department of Internal Medicine, Division of Chest Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan.
Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 350, Taiwan.
J Clin Med. 2021 Feb 11;10(4):707. doi: 10.3390/jcm10040707.
The implications of boosting Omalizumab treatment (OT) in patients with severe allergic asthma (SAA) remain unclear. The study aimed to explore and compare the 12-month effectiveness between continuous, at least 10-month OT (continuation group) and four-month boost of Omalizumab (boost group) in adult patients with SAA. In this retrospective cohort study, clinical data were collected for further analysis. Of all participants ( = 124), a significant reduction in annual exacerbations (baseline = 0.8 ± 1.5, follow-up = 0.5 ± 1.0, = 0.047 *) and improvement in small airway ventilation as evaluated by forced expiratory flow at 25-75% (baseline = 55.1 ± 11.1%, follow-up = 59.4 ± 8.4%, < 0.001 *) were found in the continuation group ( = 110). By contrast, the boost group ( = 14) had significantly increased annual exacerbations (baseline = 0.7 ± 1.4, follow-up = 2.9 ± 3.6, = 0.031 *) and impaired small airway function (baseline = 55.3 ± 12.9, follow-up = 52.1 ± 12.5, = 0.026 *). Furthermore, the continuation group rather than the boost group had significant decreases in the frequency of oral corticosteroid (OCS) use as controllers (baseline = 32.7%, follow-up = 20.0%, = 0.047 *; baseline = 50.0%, follow-up = 21.4%, = 0.237, respectively) and OCS maintenance dose (mg/month) (baseline = 85.9 ± 180.8, follow-up = 45.8 ± 106.6, = 0.020 *; baseline = 171.4 ± 221.5, follow-up = 50.0 ± 104.3, = 0.064, respectively), and increases in asthma control test scores (baseline = 16.0 ± 3.0, follow-up = 19.8 ± 4.4, < 0.001 *; baseline = 14.6 ± 3.8, follow-up = 19.7 ± 4.7, = 0.050, respectively). Continuous OT would be beneficial for adult patients with SAA, while boost of Omalizumab would worsen their long-term outcomes.
在重度过敏性哮喘（SAA）患者中增加奥马珠单抗治疗（OT）的意义仍不明确。本研究旨在探讨并比较成年SAA患者中持续至少10个月的OT（持续治疗组）与四个月的奥马珠单抗强化治疗（强化治疗组）之间的12个月疗效。在这项回顾性队列研究中，收集临床数据以进行进一步分析。在所有参与者（n = 124）中，持续治疗组（n = 110）的年度发作次数显著减少（基线 = 0.8±1.5，随访 = 0.5±1.0，P = 0.047*），并且通过25%-75%用力呼气流量评估的小气道通气有所改善（基线 = 55.1±11.1%，随访 = 59.4±8.4%，P < 0.001*）。相比之下，强化治疗组（n = 14）的年度发作次数显著增加（基线 = 0.7±1.4，随访 = 2.9±3.6，P = 0.031*），并且小气道功能受损（基线 = 55.3±12.9，随访 = 52.1±12.5，P = 0.026*）。此外，持续治疗组而非强化治疗组作为控制药物的口服糖皮质激素（OCS）使用频率显著降低（基线 = 32.7%，随访 = 20.0%，P = 0.047*；基线 = 50.0%，随访 = 21.4%，P = 0.237）以及OCS维持剂量（mg/月）显著降低（基线 = 85.9±180.8，随访 = 45.8±106.6，P = 0.020*；基线 = 171.4±221.5，随访 = 50.0±104.3，P = 0.064），并且哮喘控制测试评分增加（基线 = 16.0±3.0，随访 = 19.8±4.4，P < 0.001*；基线 = 14.6±3.8，随访 = 19.7±4.7，P = 0.050）。持续OT对成年SAA患者有益，而奥马珠单抗强化治疗会使他们的长期预后恶化。
