מתוך medicontext.co.il
NEW YORK (Reuters Health) – Omalizumab, a recombinant humanized monoclonal anti-IgE antibody, significantly reduces symptoms of seasonal allergic rhinitis, an effect that is associated with a reduction in serum-free IgE.
Dr. Thomas B. Casale, of Creighton University in Omaha, Nebraska, and associates studied patients between the ages of 12 and 75 years old who were seen at 25 outpatient centers across the US. As reported in The Journal of the American Medical Association for December 19, patients had at least a 2-year history of moderate to severe ragweed-induced allergic rhinitis and baseline IgE levels between 30 IU/mL and 700 IU/mL.
Included in the primary analysis were 125 patients randomly assigned to omalizumab 300 mg, 129 patients assigned to omalizumab 150 mg, 136 patients assigned to omalizumab 50 mg, and 132 assigned to placebo. The drug was administered subcutaneously approximately 2 weeks before ragweed season started and then every 3 weeks for those whose baseline IgE levels exceeded 150 IU/ml, and every 4 weeks for the remainder of subjects.
A linear dose-response relationship was observed for average daily nasal symptom severity scores. Those receiving 300 mg omalizumab showed minimal change in weekly nasal symptom severity scores during the entire pollen season.
Rhinitis-specific quality of life scores were consistently better in patients who were administered 300 mg of the drug than in those using lower doses or placebo. "In fact, quality of life scores were better at peak season than at study entry" among those receiving 300 mg omalizumab," the researchers report.
The proportion of subjects whose serum free IgE levels declined to <10.4 IU/mL after the first dose was 63%, 33%, 4% and 3% in the 300-mg, 150-mg, 50-mg and placebo groups, respectively.
In a commentary, Dr. Marshall Plaut, of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, points out that many children with allergic rhinitis go on to develop asthma within 2 to 5 years. However, allergen-specific immunotherapy reduces this risk.
Dr. Plaut maintains, "It will be important for future research to evaluate whether omalizumab blocks the onset of asthma."
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