Prediction of clinical response to omalizumab in moderate-to-severe asthma patients using the change in total serum IgE level.
Prediction of clinical response to omalizumab in moderate-to-severe asthma patients using the change in total serum IgE level.
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利用血清总 IgE 水平的变化预测中重度哮喘患者对奥马珠单抗的临床反应
DOI：
10.21037/jtd-20-2073
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发表时间：
2020-12
影响因子：
2.5
通讯作者：
Zhao H
中科院分区：
文献类型：
--
作者：
Li B;Huang M;Huang S;Zeng X;Yuan Y;Peng X;Zhao W;Ye Y;Yu C;Liu L;Ou C;Cai S;Zhao H
Omalizumab （OMA）是一种有效的抗免疫球蛋白E （IgE）治疗中重度哮喘的药物。然而，预测一个人的反应是困难的。监测血清总IgE的变化可能有助于预测对OMA的反应。本研究的目的是确定测量总IgE水平的变化是否可以预测中重度哮喘患者对OMA的反应。本研究纳入了25例中重度哮喘患者（女性11例，男性14例，平均年龄46.1岁，平均支气管扩张剂前FEV1% =67.8%）。所有患者均接受OMA治疗，并在治疗前基线（基线中位数血清总IgE =210 IU/mL）和开始治疗后4周测量血清总IgE浓度。治疗16周后，采用总体治疗效果（GETE）反应法将患者分为反应者（即极好或良好的反应）和无反应者（即中度或较差的反应）。比较有反应者和无反应者的特征，并采用受试者工作特征（ROC）曲线分析确定IgE水平变化预测治疗反应的能力。有20名反应者（80%）和5名无反应者（20%），与无反应者相比，反应者在哮喘控制测试（ACT）和哮喘控制问卷（ACQ）得分方面表现出更好的改善，口服皮质类固醇的使用也有所减少。21例患者4周总血清IgE与基线的比值≥2，其中20例患者对OMA有反应。基线IgE水平预测治疗反应的ROC曲线下面积（AUC）为0.53 (95% CI: 0.18-0.88)，第4周IgE水平的ROC曲线下面积（AUC）为0.69 （95% CI: 0.42-0.96）。使用截断值2,4周基线IgE比值达到最高AUC 0.87 (95% CI: 0.64-1)，预测治疗反应的敏感性和特异性分别为100%和80%。第4周总血清IgE水平：基线水平比值≥2，可高概率预测中重度哮喘患者治疗16周后对OMA的反应。监测哮喘患者治疗后总IgE水平的变化可能有助于预测临床反应。
Omalizumab (OMA) is an effective anti-immunoglobulin E (IgE) treatment for moderate-to-severe asthma. However, predicting an individual’s response is difficult. Monitoring change of total serum IgE may be useful for predicting the response to OMA. The purpose of this study was to determine if measuring the change in total IgE level could predict the response to OMA in patients with moderate-to-severe asthma. This study included 25 patients (11 females and 14 males; mean age =46.1 years; mean pre-bronchodilator FEV1% =67.8%) with moderate-to-severe asthma. All patients were treated with OMA, and total IgE serum concentrations were measured at baseline before treatment (median baseline total serum IgE =210 IU/mL) and at 4 weeks after beginning treatment. Patients were divided into responders (i.e., excellent or good response) and non-responders (i.e., moderate or poor response) using the global treatment effectiveness (GETE) response method after 16 weeks of treatment. The characteristics of responders and non-responders were compared, and receiver operating characteristic (ROC) curve analysis was used to determine the ability of change in IgE level to predict treatment response. There were 20 responders (80%) and 5 non-responders (20%), and responders demonstrated better improvements of asthma control test (ACT) and asthma control questionnaire (ACQ) scores, and reduction of oral corticosteroid use as compared with non-responders. Twenty-one patients had a total serum IgE 4-week-to-baseline ratio ≥2, and 20 of the patients responded to OMA. The area under the ROC curve (AUC) for baseline IgE level for predicting treatment response was 0.53 (95% CI: 0.18–0.88), and that of the week 4 IgE level was 0.69 (95% CI: 0.42–0.96). Using a cutoff value of 2, the 4-week: baseline IgE ratio achieved the highest AUC of 0.87 (95% CI: 0.64–1), with a sensitivity and specificity of 100% and 80%, respectively, for predicting treatment response. A total week 4 serum IgE level:baseline level ratio ≥2 can predict the response to OMA in patients with moderate-to-severe asthma after 16 weeks of treatment with high likelihood. Monitoring changes of total IgE level in asthma patients treated OMA may be useful for predicting clinical response.
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影响因子：
12.4
作者：
Ertas, R.;Ozyurt, K.;Maurer, M.
通讯作者：
Maurer, M.
影响因子：
14.2
作者：
de Groot, Jantina C.;van Roon, Eric N. H.;ten Brinke, Anneke
通讯作者：
ten Brinke, Anneke
影响因子：
14.2
作者：
Busse, W;Corren, J;Gupta, N
通讯作者：
Gupta, N
DOI：
10.3132/pcrj.2008.00031
发表时间：
2008-06-01
期刊：
Primary care respiratory journal : journal of the General Practice Airways Group
影响因子：
--
作者：
Price, David
通讯作者：
Price, David
影响因子：
24.3
作者：
Chung, Kian Fan;Wenzel, Sally E.;Teague, W. Gerald
通讯作者：
Teague, W. Gerald