Characteristics of patients with severe asthma who experienced treatment failure with omalizumab.

Adult Anti-Asthmatic Agents / therapeutic use Asthma / drug therapy Female Humans Omalizumab / therapeutic use Retrospective Studies Treatment Failure
Biologic drug ENT Omalizumab Severe asthma Treatment failure

Journal

Pulmonary pharmacology & therapeutics
ISSN: 1522-9629
Titre abrégé: Pulm Pharmacol Ther
Pays: England
ID NLM: 9715279

Informations de publication

Date de publication:
06 2021
Historique:
received: 07 08 2020
revised: 06 04 2021
accepted: 08 04 2021
pubmed: 17 4 2021
medline: 30 9 2021
entrez: 16 4 2021
Statut: ppublish

Résumé

Omalizumab, an anti-IgE antibody, has been widely used in many countries, including Japan. However, some patients do not respond to omalizumab, and the cause of treatment failure has not been fully elucidated. This study aimed to evaluate the characteristics of adult asthma patients who failed to achieve disease control with omalizumab in a real-world setting. We retrospectively reviewed the medical records of patients in Tokyo Women's Medical University Hospital between March 2009 and May 2016. The patient characteristics and factors for treatment failure with omalizumab were evaluated, as were treatment alternatives after discontinuation of omalizumab. In total, 59 patients were included in this study. The omalizumab-ineffective group had a significantly higher number of patients with eosinophilic sinusitis (P = 0.001) and eosinophilic otitis media (P = 0.023) than the omalizumab-effective group. A multivariate analysis revealed that both eosinophilic chronic rhinosinusitis (odds ratio: 23.4; P = 0.011) and eosinophilic otitis media (odds ratio: 6.71; P = 0.039) were associated with treatment failure with omalizumab. Most patients with eosinophilic comorbidities of the ear, nose, and throat (ENT) in the omalizumab-ineffective group received mepolizumab or benralizumab as alternative therapy, following which disease control was achieved. Eosinophilic comorbidities of the ENT may affect treatment failure with omalizumab in patients with severe asthma. Anti-interleukin-5 antibody or anti-interleukin-5Rα antibody rather than anti-IgE antibody should be considered as an additional therapy for patients with severe asthma who have eosinophilic comorbidities of the ENT.

Sections du résumé

BACKGROUND
Omalizumab, an anti-IgE antibody, has been widely used in many countries, including Japan. However, some patients do not respond to omalizumab, and the cause of treatment failure has not been fully elucidated.
OBJECTIVE
This study aimed to evaluate the characteristics of adult asthma patients who failed to achieve disease control with omalizumab in a real-world setting.
METHODS
We retrospectively reviewed the medical records of patients in Tokyo Women's Medical University Hospital between March 2009 and May 2016. The patient characteristics and factors for treatment failure with omalizumab were evaluated, as were treatment alternatives after discontinuation of omalizumab.
RESULTS
In total, 59 patients were included in this study. The omalizumab-ineffective group had a significantly higher number of patients with eosinophilic sinusitis (P = 0.001) and eosinophilic otitis media (P = 0.023) than the omalizumab-effective group. A multivariate analysis revealed that both eosinophilic chronic rhinosinusitis (odds ratio: 23.4; P = 0.011) and eosinophilic otitis media (odds ratio: 6.71; P = 0.039) were associated with treatment failure with omalizumab. Most patients with eosinophilic comorbidities of the ear, nose, and throat (ENT) in the omalizumab-ineffective group received mepolizumab or benralizumab as alternative therapy, following which disease control was achieved.
CONCLUSION
Eosinophilic comorbidities of the ENT may affect treatment failure with omalizumab in patients with severe asthma. Anti-interleukin-5 antibody or anti-interleukin-5Rα antibody rather than anti-IgE antibody should be considered as an additional therapy for patients with severe asthma who have eosinophilic comorbidities of the ENT.

Identifiants

DOI: 10.1016/j.pupt.2021.102032 PMID: 33862220
pubmed: 33862220
pii: S1094-5539(21)00044-4
doi: 10.1016/j.pupt.2021.102032
pii:
doi:

Substances chimiques

Anti-Asthmatic Agents 0
Omalizumab 2P471X1Z11

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102032

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Tomohiro Akaba (T)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Mitsuko Kondo (M)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Fumi Kobayashi (F)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Nahoko Honda (N)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Soshi Muramatsu (S)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Osamitsu Yagi (O)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Kiyoshi Takeyama (K)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Yukako Seo (Y)

Department of Otolaryngology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Manabu Nonaka (M)

Department of Otolaryngology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.

Etsuko Tagaya (E)

Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan. Electronic address: tagaya.etsuko@twmu.ac.jp.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Characteristics of patients with severe asthma...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents de l'appareil respiratoire › Antiasthmatiques › Characteristics of patients with severe asthma...
questionsmedicales.fr › Maladies du système immunitaire › Hypersensibilité › Hypersensibilité immédiate › Hypersensibilité respiratoire › Asthme › Characteristics of patients with severe asthma...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Characteristics of patients with severe asthma...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux humanisés › Omalizumab › Characteristics of patients with severe asthma...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Characteristics of patients with severe asthma...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Échec thérapeutique › Characteristics of patients with severe asthma...