Department of Allergy and Immunology, Bursa Uludağ University Faculty of Medicine, Bursa, Türkiye.
Tuberk Toraks. 2023 Mar;71(1):24-33. doi: 10.5578/tt.20239904.
Omalizumab, a humanized monoclonal anti-IgE antibody, has largely demonstrated its efficacy in severe allergic asthma. There are limited data about the effectiveness of omalizumab in patients with non-atopic severe persistent asthma. In this study, we aimed to determine the effect of omalizumab in patients with non-atopic severe asthma and compare the data obtained with those in patients with allergic severe asthma.
This study was an observational, retrospective, tertiary single-center study that assessed and compared the clinical outcome of adult patients with severe asthma (165 atopic and 41 non-atopic) who have been on omalizumab for one year or longer between January 2008 and January 2020. Effectiveness was assessed by considering symptom scores (GINA symptom control score), daily systemic corticosteroids (SCS) dosage, blood eosinophil counts, pulmonary function, and number of severe exacerbations and hospitalizations within the last one year.
Omalizumab exhibited significant improvement in the clinical status of non-atopic asthma patients as measured by GINA symptom score [decreased from 3.77 ± 0.63 to 1.36 ± 1.27 (p<0.001)], the number of emergency room visits for asthma [decreased from 11.25 ± 14.69 to 0.25 ± 0.55 (p<0.001)], and the number of hospitalizations [decreased from 1.17 ± 2.87 to 0.14 ± 0.36 (p= 0.036)]. These results were not significantly different from those obtained in allergic asthma patients. FEV1 improved significantly from 2.08 ± 0.86 to 2.14 ± 0.84 (p= 0.041) and oral corticosteroid doses decreased significantly from 1.67 ± 7.49 to 0.46 ± 2.74 (p= 0.015) in the only atopic group.
Omalizumab, which is a proven and effective treatment option for allergic asthma, may also be an efficacious alternative option in non-atopic severe asthma.
奥马珠单抗是一种人源化单克隆抗 IgE 抗体，在重度过敏性哮喘中已被广泛证明其疗效。关于奥马珠单抗在非过敏性重度持续性哮喘患者中的有效性，数据有限。在这项研究中，我们旨在确定奥马珠单抗在非过敏性重度哮喘患者中的疗效，并将获得的数据与过敏性重度哮喘患者的数据进行比较。
这是一项观察性、回顾性、三级单中心研究，评估并比较了自 2008 年 1 月至 2020 年 1 月期间，接受奥马珠单抗治疗一年或更长时间的 165 例过敏性重度哮喘和 41 例非过敏性重度哮喘成年患者的临床结局。通过考虑症状评分（GINA 症状控制评分）、每日全身皮质类固醇（SCS）剂量、血嗜酸性粒细胞计数、肺功能以及过去一年中严重加重和住院的次数来评估疗效。
奥马珠单抗显著改善了非过敏性哮喘患者的临床状况，表现在 GINA 症状评分上[从 3.77±0.63 降至 1.36±1.27（p<0.001）]、因哮喘急诊就诊的次数[从 11.25±14.69 降至 0.25±0.55（p<0.001）]和住院次数[从 1.17±2.87 降至 0.14±0.36（p=0.036）]。这些结果与过敏性哮喘患者的结果无显著差异。在仅为过敏性的患者中，FEV1 显著改善，从 2.08±0.86 增加到 2.14±0.84（p=0.041），口服皮质类固醇剂量从 1.67±7.49 减少到 0.46±2.74（p=0.015）。
奥马珠单抗是一种已被证实的治疗过敏性哮喘的有效方法，在非过敏性重度哮喘中也可能是一种有效的替代选择。
