Omalizumab lowers asthma exacerbations, oral corticosteroid intake and blood eosinophils: Results of a 5-YEAR single-centre observational study

Publication date: Available online 7 November 2018Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Corrado Pelaia, Cecilia Calabrese, Sarah Barbuto, Maria Teresa Busceti, Mariaimmacolata Preianò, Luca Gallelli, Rocco Savino, Alessandro Vatrella, Girolamo PelaiaAbstractOmalizumab is a humanized monoclonal antibody which binds to human immunoglobulins E (IgE), thus preventing their interactions with both high affinity and low affinity IgE receptors. Therefore, omalizumab is currently recommended for add-on biological therapy of uncontrolled allergic asthma, mainly characterized by type 2 airway eosinophilic inflammation. Because omalizumab has been the first, and for a long time the only available monoclonal antibody for add-on treatment of type 2 asthma, some long-term studies have been published which provide a clear evidence of the therapeutic effectiveness of the anti-IgE pharmacological strategy.Within this context, the present single-centre observational study refers to 15 patients with severe allergic asthma, treated with omalizumab for at least 5 years at the Respiratory Unit of “Magna Græcia” University Hospital located in Catanzaro, Italy. In these asthmatic subjects we observed significant increases in asthma control test (ACT) score, with respect to baseline (14.60 ± 2.97), after 1 year (19.20 ± 2.98; p 
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research

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We describe two case reports with severe allergic asthma who progressively worsened over the years despite the best therapy. The patients were first treated with omalizumab, which was completely ineffective, and then with bronchial thermoplasty (BT), again without clinical benefit. Since our patients met the AIFA criteria for inclusion in mepolizumab treatment, a therapy with this anti-IL5 biological agent was initiated. In the first case (a 53-year-old female), after the second mepolizumab administration, symptoms improved progressively, with a reduction in the number and severity of exacerbations, so the patient could fi...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: Irrespective of the type of allergen, long-term maintenance AIT helps to spare ICS dose and achieve better control in patients with allergic asthma in real-world clinical practice. PMID: 31743967 [PubMed]
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
AbstractObjectiveThe inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fluticasone propionate/formoterol fumarate (FP/FORM;Flutiform®) has been available as fixed-dose combination (FDC) therapy for asthma patients aged ≥ 12 years in the UK since 2012. This post-authorisation safety study examined adverse outcomes and prescribing practices for FP/FORM and other FDC ICS/LABA therapies in a real-life clinical setting over 36 months.MethodsHistorical, longitudinal cohort database study using UK primary care data from the Clinical Practice Research Datalink (CPRD) database, for patients initi...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
The complexity of asthma is underscored by the number of cell types and mediators implicated in the pathogenesis of this heterogeneous syndrome. Type 2 CD4+ T-cells (Th2) and more recently, type 2 innate lymphoid cells dominate current descriptions of asthma pathogenesis. However, another important source of these type 2 cytokines, especially interleukin (IL)-5 and IL-13, are CD8+ T-cells, which are increasingly proposed to play an important role in asthma pathogenesis, because they are abundant and are comparatively insensitive to corticosteroids. Many common triggers of asthma exacerbations are mediated via corticosteroi...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Reviews Source Type: research
A 74-year-old woman with a prior history of tobacco use presented with a chronic cough productive of clear sputum. She carried a diagnosis of asthma for the past 20 years but had minimal improvement in symptoms despite treatment with inhaled corticosteroids and long acting beta agonists. Her medical history was remarkable for gastroesophageal reflux disease that resolved after an esophageal fundoplication.
Source: The American Journal of Medicine - Category: General Medicine Authors: Source Type: research
We present a 48 year-old active duty physician who initially presented in 2007 with dyspnea and cough. Despite the absence of variable obstruction on spirometry, a clinical diagnosis of asthma was made. The patient's symptoms were temporized with inhaled corticosteroids and bronchodilators, titrated to his symptoms, until eventual therapeutic failure resulted in re-referral to pulmonary. Chest computed tomography (CT) showed ground-glass nodules and patchy airspace opacities with evidence of thoracic lymphadenopathy. A positron emission tomography CT (PET CT) showed diffuse adenopathy throughout his thorax and abdomen with...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
AbstractPurpose of this reviewTo highlight the evidence behind the various biologics that are being developed for asthma along with their specific targets in the inflammatory cascade and the potential role they serve in the management of allergic asthma.Recent findingsThe mainstay of asthma management for the majority of asthmatics is inhaled corticosteroids with or without long-acting beta-agonists and/or leukotriene modifiers and/or tiotropium. However, in the small group of individuals with severe asthma uncontrolled with conventional therapy, biologics have emerged as an effective therapeutic option.SummaryAsthma is a ...
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research
AbstractDupilumab (Dupixent®) is a fully human monoclonal antibody against the interleukin (IL)-4 receptor α subunit of IL-4 and IL-4/IL-13 receptor complexes. IL-4 and IL-13 are key cytokines in driving type 2 inflammation, a dominant and largely eosinophilic inflammatory pathway in asthma. Trials evaluating the efficacy of dupilumab in asthma include three pivotal, placebo-controlled, phase 3 or 2b tr ials of 24–52 weeks’ treatment duration in patients aged ≥ 12 years with moderate-to-severe asthma (inadequately controlled with medium-to-high dose inhaled corticosteroids) or severe asthma [d...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
CONCLUSIONS: Inhaled corticosteroids are safe in the treatment of asthma and there is no association between different doses of Inhaled corticosteroids and isolation of the pathogenic organism. PMID: 31729320 [PubMed - in process]
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
PMID: 31729319 [PubMed - in process]
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
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