Chapter

Anti-IgE: biologicals reach the inner cities

Ulrich Wahn

in Landmark Papers in Allergy

Published on behalf of Oxford University Press

Published in print February 2013 | ISBN: 9780199651559
Published online April 2013 | e-ISBN: 9780191754241 | DOI: http://dx.doi.org/10.1093/med/9780199651559.003.0091

Series: Landmark Papers

Anti-IgE: biologicals reach the inner cities

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  • Public Health and Epidemiology
  • Immunology
  • Respiratory Medicine and Pulmonology

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Background: Research has underscored the effects of exposure and sensitization to allergens on the severity of asthma in inner-city children. It has also revealed the limitations of environmental remediation and guidelines-based therapy in achieving greater disease control. Methods: We enrolled inner-city children, adolescents, and young adults with persistent asthma in a randomized, double-blind, placebo-controlled, parallel-group trial at multiple centers to assess the effectiveness of omalizumab, as compared with placebo, when added to guidelines-based therapy. The trial was conducted for 60 weeks, and the primary outcome was symptoms of asthma. Results: Among 419 participants who underwent randomization (at which point 73% had moderate or severe disease), omalizumab as compared with placebo significantly reduced the number of days with asthma symptoms, from 1.96 to 1.48 days per 2-week interval, a 24.5% decrease (P < 0.001). Similarly, omalizumab significantly reduced the proportion of participants who had one or more exacerbations from 48.8 to 30.3% (P < 0.001). Improvements occurred with omalizumab despite reductions in the use of inhaled glucocorticoids and long-acting beta-agonists. Conclusions: When added to a regimen of guidelines-based therapy for inner-city children, adolescents, and young adults, omalizumab further improved asthma control, nearly eliminated seasonal peaks in exacerbations, and reduced the need for other medications to control asthma.

Chapter.  872 words.  Illustrated.

Subjects: Public Health and Epidemiology ; Immunology ; Respiratory Medicine and Pulmonology

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