Efficacia di omalizumab: Pooled analysis della casistica italiana

Omalizumab, humanized recombining monoclonal antibody of murine origin, able to bind IgEs, consequently blocking their interaction with mastcells and basophyls, has been proven effective in the treatment of persistent moderate- to-severe (specially at high risk), IgE-mediated, asthma in adults and adolescents non-adequately 8or not at all) controlled by the best possible therapy. This Journal, in consideration of the high originality of such novel therapeutic proposal, has published in the last two years 32 contributions of Italian Authors, consisting of case reports on the effect of omalizumab in patients suffering from asthma characterised by the over mentioned characteristics. The 32 articles present 42 adult or elderly patients. The present is a pooled analysis on most important clinical, functional, pharmacological and social effects of such therapy. Sex, age and diagnosis of the patients are taken into consideration, besides to the following clinical variables: onset of improvements, symptomatologic changes, hospitalisations and emergency therapy, quality of life,use of steroids, additive use of salbutamol as "rescue" therapy, other (non-steroidal) maintenance treatments, FEV ₁. We remark that, since the patients are characterised by a relatively "old" age (49 yrs) which is often linked with inveterate asthma and due to the frequent hospitalisations and emergency visits, it can be confirmed that the patients are in general sekected between those corresponding to clinical criteria of moderate-to-severe persistent uncontrolled asthma. Particular evidence was attributed to improved quality of life, to the possibility of reducing (sometimes withdrawing) steroids and rescue salbutamol. Improvement of bronchial patency, evaluated thank to FEV ₁ (comparison of post/pre-omalizumab FEV ₁) shows clear-cut evidence in 77%, poor or no change in 23%, with +28.4% FEVi average (p>0.001). Onset of improvement has an average time of 7.8 weeks following omalizumab introduction in therapy, but is generally much earlier, residing 4 weeks in the majority of cases.