L'esperienza che insegna
Quando l’asma č “difficile”: il ruolo dell’omalizumab
Severe asthma: treatment with omalizumab
Giuseppe Vieni, Loretta Biserna, Federico Marchetti
UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
Marzo 2017 - pagg. 177 -181
Abstract
The percentage of asthmatic children with severe asthma is low (< 5%). Children with severe
asthma require treatment with high dose of inhaled steroids plus a second controller
and/or systemic steroids to control symptoms. They can also remain uncontrolled despite
these therapies. Adherence to therapy must always be controlled, especially in case of
poor response to therapy and uncontrolled symptoms. Omalizumab is a monoclonal antibody
with an anti-IgE effect that could work successfully to control symptoms in selected
children with severe asthma. Asthma guidelines consider omalizumab as last therapeutic
step in asthmatic children. The paper describes the case of a female paediatric patient
with severe asthma treated with omalizumab who had clinical benefits from it and whose
medications were gradually reduced and then stopped.
Parole chiave
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. GINA - Global Initiative for Asthma. Global
strategy for asthma management and prevention.
Updated 2015. 20th May 2015.
2. Diaz RA, Charles Z, George E, Adler AI.
NICE guidance on omalizumab for severe
asthma. Lancet Respir Med 2013;1(3):189-90.
3. Normansell R, Walker S, Milan SJ, Walters
EH, Nair P. Omalizumab for asthma in adults
and children. Cochrane Database Syst Rev
2014;(1):CD003559.
4. Busse WW, Morgan WJ, Gergen PJ, et al.
Randomized trial of omalizumab (anti-IgE)for
asthma in inner-city children. N Engl J Med
2011;364(11):1005-15.
5. Ledford D, Busse W, Trzaskoma B, et al. A
randomized, multicenter study evaluating Xolair
persistency of response after long-term
therapy. J Allergy Clin Immunol 2016 Nov 5
[Epub ahead of print].
6. Abraham I, Alhossan A, Lee CS, Kutbi H,
MacDonald K. “Real-life” effectiveness studies
of omalizumab in adult patients with severe allergic
asthma: systematic review. Allergy
2016;71(5):593-610.
7. Molimard M, Mala L, Bourdeix I, Le Gros
V. Observational study in severe asthmatic patients
after discontinuation of omalizumab for
good asthma control. Respir Med 2014;108(4):
571-6.
8. Corren J, Casale TB, Lanier B, Buhl R, Holgate
S, Jimenez P. Safety and tolerability of omalizumab.
Clin Exp Allergy 2009;39(6):788-97.
9. Rodrigo GJ, Neffen H, Castro-Rodriguez JA.
Efficacy and safety of subcutaneous omalizumab
vs. placebo as add-on therapy to corticosteroids
for children and adults with asthma: a
systematic review. Chest 2011;139(1):28-35.
10. Licari A, Marseglia A, Caimmi S, et al.
Omalizumab in children. Paediatr Drugs 2014;
16(6):491-502.
11. Canonica GW, Senna G, Mitchell PD,
O’Byrne PM, Passalacqua G, Varricchi G.
Therapeutic interventions in severe asthma.
World Allergy Organ J 2016;9(1):40.
12. Pillai P, Chan YC, Wu SY, et al. Omalizumab
reduces bronchial mucosal IgE and improves
lung function in non-atopic asthma. Eur
Respir J 2016;48(6):1593-601.
13. Papathanassiou E, Loukides S, Bakakos P.
Severe asthma: anti-IgE or anti-IL-5? Eur Clin
Respir J 2016;3:31813.
14. Burch J, Griffin S, McKenna C, et al.Omalizumab
for the treatment of severe persistent
allergic asthma in children aged 6-11 years: a
NICE single technology appraisal. Pharmacoeconomics
2012;30(11):991-1004.
Corrispondenza: giuseppevieni@libero.it
