The use of omalizumab in the treatment of severe allergic asthma: A clinical experience update
The use of omalizumab in the treatment of severe allergic asthma: A clinical experience update
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DOI：
10.1016/j.rmed.2009.03.008
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发表时间：
2009-08-01
影响因子：
4.3
通讯作者：
Jimenez, Pablo
中科院分区：
文献类型：
--
作者：
Holgate, Stephen;Buhl, Roland;Jimenez, Pablo
严重的持续性哮喘会导致大量的。发病率和死亡率负担沉重，尽管进行了基于指南的强化治疗，但往往得不到充分控制。靶向严重持续性哮喘发病机制的过敏性炎症过程可改善相当比例患者的哮喘控制。Omalizumab是一种人源化单克隆哮喘免疫球蛋白E （IgE）抗体，已开发用于靶向IgE， IgE是触发和维持过敏性气道炎症的核心。在一个全面的临床试验项目中，omalizumab已被证明可以减少哮喘恶化和急诊就诊率，并改善严重持续性过敏性哮喘患者的生活质量。很难预测哪些患者将从奥玛珠单抗治疗中获益最多；准确的患者选择和给药是实现获益的关键。患者需要有令人信服的IgE介导哮喘，并根据治疗前血清总IgE水平和体重，使用指定的给药表给药。根据临床试验数据分析，建议在治疗16周后由医师评估治疗效果。只有对有反应者，即经医生判断已取得明显改善或完全控制哮喘的患者，才应继续治疗。Omalizumab通常耐受性良好。过敏样反应是罕见的（0.1%的患者），比遇到其他生物制剂更少见。(C) 2009年Elsevier Ltd.出版
Severe persistent asthma causes a substantial. morbidity and mortality burden and is frequently inadequately controlled despite intensive guideline-based therapy. Targeting allergic inflammatory processes that underlie the pathogenesis of severe persistent asthma improves asthma control in a significant proportion of patients. Omalizumab, a humanized monoclonal asthma-immunoglobulin E (IgE) antibody, has been developed to target IgE, which is central to triggering and maintaining allergic airway inflammation. In a comprehensive program of clinical trials, omalizumab has been shown to reduce asthma exacerbation and emergency visit rates, and to improve quality of life in patients with severe persistent allergic asthma. It is difficult to predict which patients would most benefit from omalizumab treatment; accurate selection and dosing of patients are essential to achieve benefit. Patients need to have convincing IgE-mediated asthma and be dosed according to pre-treatment serum total IgE level and body weight, using a specified dosing table. Based on clinical trial data analysis, it is recommended that treatment response is evaluated by the physician after 16 weeks of therapy. Treatment should only be continued in responders, i.e. those judged by the physician to have achieved a marked improvement or complete asthma control. Omalizumab is generally well tolerated. Anaphylactic-like reactions are rare (0.1% of patients) and less common than encountered with other biologics. (C) 2009 Published by Elsevier Ltd.