Can omalizumab solve the problem of inadequate controlled severe persistent asthma patient

International Conference on Pulmonary & Respiratory Medicine

October 29-31, 2012 DoubleTree by Hilton Chicago-North Shore, USA

Abdalla A Abu Hussein

Accepted Abstracts: J Pulmon Resp Med

Abstract :

Aim of the study: We determined the effect of omalizumab on clinically significant asthma exacerbations (requiring systemic corticosteroids). Background: Over 300 million individuals worldwide have asthma1 of whom the majority have mild or moderate disease that can be controlled by inhaled corticosteroids, either alone or in combination with inhaled longacting β2 agonist bronchodilators.1?3 Nevertheless a considerable proportion of patients with asthma, 4 particularly those with severe disease5 have poorly controlled symptoms and are at increased risk of exacerbations. In some patients inadequately controlled asthma is due to poor adherence with treatment, untreated co-morbidities, dysfunctional breathing or psychological problems.5,6 For others, there is a need for additional or new therapies.7 Severe asthma occurs in 5% to 10% of the asthmatic population and in this group it is estimated that over 50% have allergic IgE-mediated asthma.9 Omalizumab, a recombinant humanized monoclonal antibody that binds circulating IgE antibody, is a treatment option for moderate to severe allergic asthma in patients whose asthma is not well controlled with inhaled corticosteroids and inhaled long-acting β2 agonist bronchodilators.1?3 Methods: Following a run-in phase, patients (12-75 years) inadequately controlled with high-dose inhaled corticosteroids (ICS) and long-acting beta(2)-agonists (LABA) with reduced lung function and a recent history of clinically significant exacerbations were randomized to receive omalizumab or placebo for 24 weeks in a double-blind, parallel-group study. Results: A total of 51 patients were included in the efficacy analyses. (30 treated with omalizumab), 95% of whom had severe persistent asthma according to the Global Initiative for Asthma (GINA) 2011 update. Omalizumab significantly reduced the rate of asthma exacerbations by 40% (P < 0.0001 vs control) and the rate of total emergency visits by 44% (P < 0.0001 vs control). Omalizumab significantly improved asthma-related quality of life, morning peak expiratory flow and asthma symptom scores. Conclusion: In patients with inadequately controlled severe persistent asthma, despite high-dose ICS and LABA therapy, omalizumab significantly reduced the rate of clinically significant asthma exacerbations, severe exacerbations and emergency visits.