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首页> 外文期刊>The annals of pharmacotherapy >Anti-immunoglobulin E therapy with omalizumab for asthma.
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Anti-immunoglobulin E therapy with omalizumab for asthma.

机译:omalizumab的抗免疫球蛋白E治疗哮喘。

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摘要

OBJECTIVE: To evaluate data on anti-immunoglobulin E (anti-IgE) therapy for asthma. DATA SOURCES: Information was selected from PubMed from 1989 to May 2007 using the search term omalizumab and included randomized, controlled trials. These studies evaluated asthma treatment with omalizumab and focused on its efficacy, tolerability, and cost-effectiveness in this population. STUDY SELECTION AND DATA EXTRACTION: All randomized clinical trials were reviewed (23 were identified and 19 were included; 3 were not relevant and 1 contained duplicative data). Other articles using the search words anti-IgE therapy and cost-effectiveness were evaluated; relevant information was extracted. DATA SYNTHESIS: IgE-dependent mechanisms play an important role in the development and maintenance of airway inflammation in asthma. Omalizumab is a subcutaneously administered monoclonal anti-IgE antibody that reduces unbound IgE concentrations and promotes down-regulation of IgE receptors. Results from clinical trials in adults, adolescents, and children with poorly controlled IgE-mediated asthma have shown that omalizumab improves symptom control and allows patients to be managed with lower doses of inhaled corticosteroids (ICS). It has been well tolerated in clinical trials lasting as long as 52 weeks, but injection-site reactions are common (45% in omalizumab group vs 43% in placebo group) and anaphylaxis has occurred in 0.2% of patients. A consensus expert panel has recommended that omalizumab should be considered for patients 12 years of age or older with allergic asthma who are inadequately controlled on guideline-based therapy and require maintenance therapy with systemic corticosteroids or high-dose ICSs, or who have poor adherence to ICS therapy. CONCLUSIONS: Anti-IgE therapy provides an effective and generally safe approach to the treatment of patients with IgE-mediated asthma who are not adequately controlled by conventional guideline-based medications. However, the potential benefit must be weighed against the cost and inconvenience of this new therapy.
机译:目的:评估抗免疫球蛋白E(IgE)治疗哮喘的数据。数据来源:信息来自1989年至2007年5月的PubMed,使用搜索词omalizumab,包括随机对照试验。这些研究评估了奥马珠单抗对哮喘的治疗,并集中于该人群的疗效,耐受性和成本效益。研究选择和数据提取:审查了所有随机临床试验(确定了23项,包括19项; 3项无关,1项包含重复数据)。对使用搜索词抗IgE治疗和成本效益的其他文章进行了评估;提取了相关信息。数据综合:IgE依赖性机制在哮喘气道炎症的发生和维持中起着重要作用。奥马珠单抗是一种皮下给药的单克隆抗IgE抗体,可降低未结合的IgE浓度并促进IgE受体的下调。在成人,青少年和IgE介导的哮喘控制不佳的儿童中进行的临床试验结果表明,奥马珠单抗可改善症状控制,并允许患者接受较低剂量的吸入糖皮质激素(ICS)治疗。它在长达52周的临床试验中具有良好的耐受性,但注射部位的反应很常见(奥马珠单抗组为45%,而安慰剂组为43%),而0.2%的患者发生了过敏反应。共识性专家小组建议,对于12岁或12岁以上的过敏性哮喘,在基于指南的治疗中控制不力,需要全身性糖皮质激素或大剂量ICS维持治疗或依从性差的患者,应考虑使用Omalizumab ICS疗法。结论:抗IgE疗法为治疗IgE介导的哮喘患者提供了一种有效且普遍安全的方法,这些患者不能接受常规指南药物的充分控制。但是,必须权衡这种新疗法的成本和不便所带来的潜在利益。

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