KONDO Mitsuko
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor (Fixed Term)
Article types Original article
Language English
Peer review Peer reviewed
Title Characteristics of patients with severe asthma who experienced treatment failure with omalizumab.
Journal Formal name:Pulmonary pharmacology & therapeutics
Abbreviation:Pulm Pharmacol Ther
ISSN code:15229629/10945539
Domestic / ForeginForegin
Volume, Issue, Page 68,pp.102032
Author and coauthor Akaba Tomohiro†, Kondo Mitsuko, Kobayashi Fumi, Honda Nahoko, Muramatsu Soshi, Yagi Osamitsu, Takeyama Kiyoshi, Seo Yukako, Nonaka Manabu, Tagaya Etsuko
Publication date 2021/06
Summary BACKGROUND:Omalizumab, an anti-IgE antibody, has been widely used in many countries, including Japan. However, some patients do not respond to omalizumab, and the cause of treatment failure has not been fully elucidated.OBJECTIVE:This study aimed to evaluate the characteristics of adult asthma patients who failed to achieve disease control with omalizumab in a real-world setting.METHODS:We retrospectively reviewed the medical records of patients in Tokyo Women's Medical University Hospital between March 2009 and May 2016. The patient characteristics and factors for treatment failure with omalizumab were evaluated, as were treatment alternatives after discontinuation of omalizumab.RESULTS:In total, 59 patients were included in this study. The omalizumab-ineffective group had a significantly higher number of patients with eosinophilic sinusitis (P = 0.001) and eosinophilic otitis media (P = 0.023) than the omalizumab-effective group. A multivariate analysis revealed that both eosinophilic chronic rhinosinusitis (odds ratio: 23.4; P = 0.011) and eosinophilic otitis media (odds ratio: 6.71; P = 0.039) were associated with treatment failure with omalizumab. Most patients with eosinophilic comorbidities of the ear, nose, and throat (ENT) in the omalizumab-ineffective group received mepolizumab or benralizumab as alternative therapy, following which disease control was achieved.CONCLUSION:Eosinophilic comorbidities of the ENT may affect treatment failure with omalizumab in patients with severe asthma. Anti-interleukin-5 antibody or anti-interleukin-5Rα antibody rather than anti-IgE antibody should be considered as an additional therapy for patients with severe asthma who have eosinophilic comorbidities of the ENT.
DOI 10.1016/j.pupt.2021.102032
PMID 33862220