Long-term safety, efficacy, pharmacokinetics and pharmacodynamics of omalizumab in children with severe uncontrolled asthma
Hiroshi Odajima, Motohiro Ebisawa, Toshikazu Nagakura, Takao Fujisawa, Akira Akasawa, Komei Ito, Satoru Doi, Koichi Yamaguchi, Toshio Katsunuma, Kazuyuki Kurihara, Takahide Teramoto, Kazuko Sugai, Mitsuhiko Nambu, Akira Hoshioka, Shigemi Yoshihara, Norio Sato, Noriko Seko, Sankei Nishima, Hiroshi Odajima, Motohiro Ebisawa, Toshikazu Nagakura, Takao Fujisawa, Akira Akasawa, Komei Ito, Satoru Doi, Koichi Yamaguchi, Toshio Katsunuma, Kazuyuki Kurihara, Takahide Teramoto, Kazuko Sugai, Mitsuhiko Nambu, Akira Hoshioka, Shigemi Yoshihara, Norio Sato, Noriko Seko, Sankei Nishima
Abstract
Background: Omalizumab is effective and well-tolerated in children with moderate to severe allergic asthma. However, the effects of long-term treatment with omalizumab in this population haven't been well investigated. The objective of this study is to evaluate the long-term safety, efficacy, pharmacokinetics and pharmacodynamics of omalizumab in children with uncontrolled severe asthma.
Methods: Thirty-eight Japanese children (aged 7-16 years) who completed the 24-week treatment core study were included in an uncontrolled extension study, in which treatment with omalizumab continued until the pediatric indication was approved in Japan (ClinicalTrials.gov number: NCT01328886).
Results: Thirty-five patients (92.1%) completed the extension study. The median exposure throughout the core and extension studies was 116.6 weeks (range, 46.9-151.1 weeks). The most common adverse events were nasopharyngitis, influenza, upper respiratory tract infection, and asthma. Serious adverse events developed in 10 patients (26.3%), but resolved completely with additional treatments. Incidence of adverse events didn't increase with extended exposure with omalizumab. Twenty-nine patients (76.3%) achieved completely- or well-controlled asthma compared with 9 patients (23.7%) at the start of the extension study. QOL scores, the rates (per year) of hospitalizations and ER visits were significantly improved compared with the baseline of the core study [39.0 vs 48.0 (median), p < 0.001 for QOL, 1.33 vs 0.16, p < 0.001 for hospitalization, 0.68 vs 0.15, p = 0.002 for ER visits]. Remarkably, the mean total IgE level showed a decreasing trend while exposure to omalizumab remained at steady-state.
Conclusions: Long-term treatment with omalizumab is well-tolerated and effective in children with uncontrolled severe allergic asthma. No new safety findings were identified.
Keywords: Childhood asthma; Efficacy; Omalizumab; Safety evaluation; Total IgE.
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Source: PubMed