PMID- 12917972
OWN - NLM
STAT- MEDLINE
DCOM- 20030925
LR  - 20181221
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 3
DP  - 2003
TI  - Anti-IgE for chronic asthma.
PG  - CD003559
AB  - BACKGROUND: Omalizumab is a recombinant humanised monoclonal antibody directed 
      against immunoglobulin E (IgE) to inhibit the immune system's response to 
      allergen exposure. Omalizumab is directed against the binding site of IgE for its 
      high affinity Fc receptor. It prevents free serum IgE from attaching to mast 
      cells and other effector cells and prevents IgE mediated inflammatory changes. 
      The complexes of Omalizumab and IgE formed as a result of treatment are small and 
      not thought to be able to trigger complement activation or give rise to immune 
      complex mediated pathology. OBJECTIVES: To determine the efficacy of anti-IgE in 
      patients with allergic asthma. SEARCH STRATEGY: We searched the Cochrane Airways 
      Group Asthma trials register (February 2003) for potentially relevant studies. 
      SELECTION CRITERIA: Randomised control trials examining anti-IgE administered in 
      any manner for any duration. DATA COLLECTION AND ANALYSIS: Two reviewers 
      independently assessed study quality and extracted and entered data. Three modes 
      of administration were identified from the published literature (inhaled, 
      intravenous and subcutaneous injection). Subgroup analysis was performed by 
      asthma severity. Data were extracted from published and unpublished sources. MAIN 
      RESULTS: Eight trials were included in the review, contributing a total of 2037 
      mild to severe allergic asthmatic participants with high levels of IgE. Treatment 
      with intravenous and subcutaneous Omalizumab resulted in a 98 to 99% reduction in 
      free IgE, reductions which were not observed following placebo treatment. 
      Significant increases in the number of participants who were able to reduce (> 
      50% reduction in daily corticosteroid usage (four trials): odds ratio (OR) 2.50, 
      95% confidence interval (CI) 2.02 to 3.10; or completely withdraw their daily 
      steroid intake (four trials): OR 2.50, 95%CI 2.00 to 3.13, were observed. 
      Participants treated with Omalizumab were less likely to suffer an asthma 
      exacerbation (stable steroid phase (three trials): OR 0.46, 95%CI 0.35 to 0.61; 
      steroid reduction phase (three trials) OR 0.46, 95% CI 0.36 to 0.59). REVIEWER'S 
      CONCLUSIONS: Omalizumab was significantly more effective than placebo at 
      increasing the numbers of patients who were able to reduce or withdraw their 
      inhaled steroids and was effective in reducing asthma exacerbations. Omalizumab 
      was well tolerated, although the safety profile requires longer term assessment. 
      Patient and physician assessment of the drug was positive. Further assessment in 
      paediatric and severe adult populations is necessary, as is comparison with 
      inhaled corticosteroids.
FAU - Walker, S
AU  - Walker S
AD  - National Respiratory Training Centre, The Athenaeum, 10 Church Street, Warwick, 
      UK, CV34 4AB.
FAU - Monteil, M
AU  - Monteil M
FAU - Phelan, K
AU  - Phelan K
FAU - Lasserson, T J
AU  - Lasserson TJ
FAU - Walters, E H
AU  - Walters EH
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Anti-Idiotypic)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (anti-IgE antibodies)
RN  - 2P471X1Z11 (Omalizumab)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
CIN - ACP J Club. 2004 Jan-Feb;140(1):13. PMID: 14711284
UIN - Cochrane Database Syst Rev. 2004;(3):CD003559. PMID: 15266491
MH  - Anti-Asthmatic Agents/therapeutic use
MH  - Antibodies, Anti-Idiotypic/*therapeutic use
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Asthma/*drug therapy/immunology
MH  - Chronic Disease
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Omalizumab
MH  - Randomized Controlled Trials as Topic
RF  - 36
EDAT- 2003/08/15 05:00
MHDA- 2003/09/26 05:00
CRDT- 2003/08/15 05:00
PHST- 2003/08/15 05:00 [pubmed]
PHST- 2003/09/26 05:00 [medline]
PHST- 2003/08/15 05:00 [entrez]
AID - 10.1002/14651858.CD003559 [doi]
PST - ppublish
SO  - Cochrane Database Syst Rev. 2003;(3):CD003559. doi: 10.1002/14651858.CD003559.