奥玛珠单抗对哮喘患者食物过敏的影响：一项真实世界研究
2019/03/21
摘要
背景：奥玛珠单抗对食物过敏阈值的影响研究很少。
目的：探讨奥马单抗对重症哮喘患儿食物耐受性的影响。
方法：在这项观察、现实、有效性研究中，我们回顾了严重哮喘患者的食物过敏原阈值，以及他们在奥马利珠单抗治疗4个月前后对2+食物的即时反应。我们还通过儿科生活质量量表（PEDSQL）评估了他们对哮喘的控制和生活质量。
结果：15名儿童对37种食物过敏。omalizumab诱导牛奶、鸡蛋、小麦和榛子的过敏原阈值从平均1012.6±1464.5 mg蛋白增加到8727±6463.3诱导剂量（p<0.001）。在奥马利珠单抗治疗4个月后，共有70.4%的受试者耐受完全激发剂量。这些食物被重新引入患者的饮食中，不需要任何口服免疫治疗程序。其余的食物都有部分的耐受性。4个月内对意外摄入过敏性食物的反应数量从47个下降到2个。PEDSQL从61±5.32增加到87±7.33（父母判断，P<0.001），从65±7.39增加到90±4.54（患者判断，P<0.001）。Omalizumab的平均成本为每月1311.63欧元。
结论：奥马唑单抗治疗严重哮喘时，食物过敏原阈值增加到原来值的8.6倍。由于更好地控制哮喘和减少饮食限制，患者的生活质量也提高了。对于选定的食物过敏病例，这种治疗的成本/效益比仍有待评估。
Impact of Omalizumab on Food Allergy in Patients Treated for Asthma: A Real-Life Study.
Fiocchi A, Artesani MC, Riccardi C, Mennini M, Pecora V, Fierro V, Calandrelli V, Dahdah L, Valluzzi RL.
Abstract
BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.
OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.
METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).
RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.
CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.
背景：奥玛珠单抗对食物过敏阈值的影响研究很少。
目的：探讨奥马单抗对重症哮喘患儿食物耐受性的影响。
方法：在这项观察、现实、有效性研究中，我们回顾了严重哮喘患者的食物过敏原阈值，以及他们在奥马利珠单抗治疗4个月前后对2+食物的即时反应。我们还通过儿科生活质量量表（PEDSQL）评估了他们对哮喘的控制和生活质量。
结果：15名儿童对37种食物过敏。omalizumab诱导牛奶、鸡蛋、小麦和榛子的过敏原阈值从平均1012.6±1464.5 mg蛋白增加到8727±6463.3诱导剂量（p<0.001）。在奥马利珠单抗治疗4个月后，共有70.4%的受试者耐受完全激发剂量。这些食物被重新引入患者的饮食中，不需要任何口服免疫治疗程序。其余的食物都有部分的耐受性。4个月内对意外摄入过敏性食物的反应数量从47个下降到2个。PEDSQL从61±5.32增加到87±7.33（父母判断，P<0.001），从65±7.39增加到90±4.54（患者判断，P<0.001）。Omalizumab的平均成本为每月1311.63欧元。
结论：奥马唑单抗治疗严重哮喘时，食物过敏原阈值增加到原来值的8.6倍。由于更好地控制哮喘和减少饮食限制，患者的生活质量也提高了。对于选定的食物过敏病例，这种治疗的成本/效益比仍有待评估。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2019 Feb 20. pii: S2213-2198(19)30076-5. doi: 10.1016/j.jaip.2019.01.023.)
(J Allergy Clin Immunol Pract. 2019 Feb 20. pii: S2213-2198(19)30076-5. doi: 10.1016/j.jaip.2019.01.023.)
Impact of Omalizumab on Food Allergy in Patients Treated for Asthma: A Real-Life Study.
Fiocchi A, Artesani MC, Riccardi C, Mennini M, Pecora V, Fierro V, Calandrelli V, Dahdah L, Valluzzi RL.
Abstract
BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.
OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.
METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).
RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.
CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.
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运动训练作为孟鲁司特治疗轻度哮喘的辅助治疗:一项随机对照试验
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抗生素治疗与系统性皮质类固醇治疗哮喘加重住院患者结局的关系
