China
Africa
Explore chapters and articles related to this topic
Pulmonary – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Treatment options for ABPA or SAFS are limited and the chronic relapsing nature of this disease further complicates management. Corticosteroids, which suppress the hypersensitivity reaction, and anti-fungal drugs (i.e. itraconazole 200 mg twice daily for 4 months) are regarded as first- and second-line agents. Biological therapy might have a role but has not been evaluated extensively. Omalizumab has been used but most patients have blood IgE levels that are above the current prescription dosing range imposed for clinical use. There could be a role for other biological therapies targeting type-2 cytokines but this needs to be studied.
Nasal Polyposis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Recent advances in biological treatments have resulted in availability of therapeutic monoclonal antibodies (mAbs) targeting several key mediators of NP pathogenesis that can potentially improve treatment of nasal polyposis in the setting of type 2 CRS: Omalizumab binds free circulating IgE, downregulates the expression of IgE receptors on mast cells/basophils and reduces release of inflammatory mediators ([IL-4).Dupilumab is an mAb to IL-4 receptor that inhibits the signaling of IL-4/IL-13 and reduces Th2-mediated inflammation. It is the only biological therapy approved for use in CRSwNP.Mepolizumab prevents activation of IL-5 receptors by binding to IL-5, which is important for differentiation/maturation/survival of eosinophils in tissue.
Respiratory disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Several biological drugs have been developed to treat allergic asthma including dupilumab and omalizumab. There are currently only pregnancy data for omalizumab which targets IgE which suggest no increased risk of congenital abnormality.
Evaluation of the clinical features and laboratory data of patients with severe asthma classified as super-responder or non super-responder to omalizumab treatment: a single-center real-life study
Published in Journal of Asthma, 2023
Mehmet Erdem Cakmak, Nida Öztop, Osman Ozan Yeğit, Özlem Özdedeoğlu
Omalizumab, a humanized monoclonal anti-IgE antibody, was approved for the treatment of severe allergic asthma in the USA in 2003 and in Europe in 2005 (2). It is indicated for patients with severe allergic asthma aged >6 years, who have not obtained asthma control with the standard asthma treatment, and who are sensitive to a perennial allergen. Omalizumab binds free IgE and reduces mast cell degranulation by preventing IgE from binding to its receptors on mast cells, basophils and antigen presenting cells. It also reduces T2 inflammation (3). In severe allergic asthma, omalizumab treatment has been shown to reduce exacerbations (4). In real-life studies, some patients with severe allergic asthma have shown a good response to omalizumab treatment, but some patients have had a poor response. The aim of this study was to evaluate the clinical features and laboratory data of patients with severe allergic asthma who were classified as a super-responder or non super-responder to omalizumab treatment.
Pediatric chronic spontaneous urticaria: a brief clinician’s guide
Published in Expert Review of Clinical Immunology, 2022
Martina Votto, Giovanna Achilli, Maria De Filippo, Amelia Licari, Alessia Marseglia, Alice Moiraghi, Antonio Di Sabatino, Gian Luigi Marseglia
Dekkers et al. have conducted the most extensive daily practice cohort study of pediatric patients with CU being treated with omalizumab. They confirm the safety profile of omalizumab as 68.4% of patients did not experience any side effects or only mild side effects (headache, fatigue, skin hyperemia/edema at the injection site) [62]. About 76% of children achieved a good or complete response, comparable to daily practice studies in adult patients. Also, the percentage of pediatric patients (26.3%) using a dose of Omalizumab higher than 300 mg was similar to that of adult patients (27%) [62]. A recent study of 10 pediatric studies confirmed omalizumab’s efficacy and safety in patients < 12 years with CU [63,64]. Finally, another recent review reported that 81% of children (< 12 years) with CU achieved a complete response to omalizumab and 19% a partial response, without cases of non-responders [64]. Therefore, omalizumab may be considered a promising off-label treatment option for school-aged children with CU refractory to conventional antihistamine therapy, but further studies should be performed to obtain regulatory approval for its use in this age group.
Acceptance and results of therapy with omalizumab in real world Kerala setting: reports from the ARTWORK study, Kerala, South India
Published in Journal of Asthma, 2022
Rajesh Venkitakrishnan, Melcy Cleetus, Jolsana Augustine, Divya Ramachandran, Susan John, Anand Vijay, Aparna S. Nirmal, Anju Sasi, Elda Kuriachen
The ARTWORK study reveals some interesting real life observations on omalizumab therapy in India. Sixty-eight percent of deserving and suitable patients with uncontrolled asthma opt out of omalizumab therapy. Unrealistic perception of good asthma control and huge cost of therapy are the commonest causes of rejecting omalizumab therapy. Most patients who opt for omalizumab take the agent for 6–9 months only. Omalizumab renders good asthma control in the real word scenario as evidenced by improvement in asthma scores, lesser need for maintenance systemic steroid therapy and fewer exacerbations. These benefits persist to a significant extent even after 6 months of cessation of therapy. Prospective studies recruiting larger number of patients are needed to replicate and confirm the findings of our study.