Small, Prospective, Observational, Pilot Study in Patients with Severe Asthma after Discontinuation of Omalizumab Treatment
Language English Country United States Media print-electronic
Document type Journal Article, Observational Study, Research Support, Non-U.S. Gov't
PubMed
30391022
DOI
10.1016/j.clinthera.2018.09.004
PII: S0149-2918(18)30424-7
Knihovny.cz E-resources
- Keywords
- Asthma Control Test, inhaled corticosteroids, omalizumab, severe asthma, skin prick test,
- MeSH
- Anti-Asthmatic Agents administration & dosage MeSH
- Asthma drug therapy physiopathology MeSH
- Adult MeSH
- Eosinophils metabolism MeSH
- Adrenal Cortex Hormones therapeutic use MeSH
- Quality of Life * MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Omalizumab administration & dosage MeSH
- Nitric Oxide metabolism MeSH
- Pilot Projects MeSH
- Prospective Studies MeSH
- Retrospective Studies MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anti-Asthmatic Agents MeSH
- Adrenal Cortex Hormones MeSH
- Omalizumab MeSH
- Nitric Oxide MeSH
PURPOSE: Omalizumab has demonstrated clinical efficacy in severe allergic asthma by reducing exacerbation rates and increasing quality of life. However, data concerning its sustained effect after treatment discontinuation are still needed. METHODS: This analysis was an observational pilot study (simple within-subjects design) of 12 patients experiencing severe asthma, treated with omalizumab, for 1 year after treatment discontinuation. We prospectively analyzed clinical measurements (pulmonary functions, inhaled corticosteroid [ICS] doses, Asthma Control Test [ACT] scores, skin prick test [SPT] positivity, fraction of exhaled nitric oxide, and exacerbation rates) and laboratory test results (eosinophils and total immunoglobulin E levels) at the time of discontinuation and 6 and 12 months thereafter. Baseline data (before the treatment period; range, 11-61 months) were collected retrospectively. The treatment effect until discontinuation was calculated. To determine its persistence, repeated measures were compared with baseline levels and analyzed by using a general linear model for repeated measures or the Friedman ANOVA, and χ2 tests in case of normality assumption violation or frequencies. Post hoc analysis was applied by using a simple or repeated contrasts analysis or Wilcoxon signed rank test with Bonferroni correction. FINDINGS: We proved a significant reduction in ICS doses and SPT reactivity and an increase in ACT score during the retrospective treatment phase. Moreover, persistence of these statistically significant effects was recorded 6 months after treatment discontinuation. ACT score and ICS doses (but not SPT reactivity) remained improved for 12 months after discontinuation of omalizumab treatment. IMPLICATIONS: Omalizumab treatment exhibited sustained treatment benefit after its discontinuation for patients experiencing severe allergic asthma.
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