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Randomized Controlled Trial
Oral corticosteroid sparing with omalizumab in severe allergic (IgE-mediated) asthma patients.
- Zenon Siergiejko, Ewa Świebocka, Nicola Smith, Clare Peckitt, Jo Leo, Guy Peachey, and Robert Maykut.
- Respiratory System Diagnostics and Bronchoscopy Department, Medical University of Białystok, Poland. siergiejko@csk.pl
- Curr Med Res Opin. 2011 Nov 1; 27 (11): 2223-8.
BackgroundLong-term oral corticosteroid (OCS) therapy and related adverse events are associated with a significant burden on patients and healthcare resources.MethodsThis subgroup analysis of a randomized, open-label, parallel-group study evaluated the OCS-sparing effect of omalizumab (OMA) added to optimized asthma therapy (OAT), compared with OAT alone. Patients (12-75 years) with severe allergic asthma, uncontrolled despite GINA 2004 Step 4 therapy, received OMA or OAT for 32 weeks. The change from baseline in OCS use by Week 32 in patients requiring maintenance OCS at baseline was assessed in terms of percent OCS dose change and numbers of patients with reduced/stopped or maintained/increased OCS.ResultsEighty-two patients were receiving maintenance OCS at baseline (OMA/OAT n = 59, OAT n = 23). Change from baseline in mean maintenance OCS dose at Week 32 was significantly greater in the OMA/OAT group compared with the OAT group (-45% vs. + 18.3%, p = 0.002). In the OMA/OAT group, 37 patients (62.7%) reduced/stopped OCS use at Week 32, compared with seven patients (30.4%) receiving OAT (p = 0.013). Improvements in other efficacy outcomes were seen at Week 32 in the OMA/OAT group, irrespective of OCS use. An investigator global evaluation of treatment effectiveness at Week 16 was an effective predictor of persistent treatment response at 32 weeks for the majority of OMA/OAT patients (93%), also irrespective of OCS use.ConclusionIn this open-label study of patients with severe allergic asthma, OMA/OAT therapy reduced maintenance OCS use, compared with OAT alone. Improvements in efficacy measures were observed in the OMA/OAT group, irrespective of OCS change. CLINICALTRIALS.GOV IDENTIFIER: NCT00264849.
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