- Title
- Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria
- Creator
- Hew, M.; Gillman, A.; Rimmer, J.; Katsoulotos, G. P.; Cook, M.; Yang, I.; Katelaris, C.; Bowler, S.; Langton, D.; Wright, C.; Bint, M.; Yozghatlian, V.; Sutherland, M.; Powell, H.; McDonald, V. M.; Gibson, P. G.; Wark, P.; Bowden, J.; Guo, M.; Reddel, H. K.; Jenkins, C.; Marks, G. B.; Thien, F.
- Relation
- Clinical and Experimental Allergy Vol. 46, Issue 11, p. 1407-1415
- Publisher Link
- http://dx.doi.org/10.1111/cea.12774
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2016
- Description
- Background: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30¿1500 IU/mL) and bodyweight (30-150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR). Objectives: To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. Methods: Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). Results: Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV₁) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV₁. Conclusions and Clinical Relevance: Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.
- Subject
- asthma; omalizumab; dosing range
- Identifier
- http://hdl.handle.net/1959.13/1328109
- Identifier
- uon:25828
- Identifier
- ISSN:0954-7894
- Language
- eng
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