PMID- 30961951
OWN - NLM
STAT- MEDLINE
DCOM- 20200501
LR  - 20200501
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 150
DP  - 2019 Apr
TI  - Omalizumab as alternative to chronic use of oral corticosteroids in severe 
      asthma.
PG  - 51-62
LID - S0954-6111(19)30039-3 [pii]
LID - 10.1016/j.rmed.2019.02.003 [doi]
AB  - Systemic/oral corticosteroids (OCS) have been used for decades in the management 
      of acute asthma exacerbations and chronically in patients with uncontrolled 
      severe asthma. However, while OCS are effective at treating acute exacerbations, 
      there is only empirical evidence regarding the efficacy of OCS at reducing the 
      rate of exacerbations. Evidence, although scarce, is suggestive of high 
      exacerbation rates in severe asthma patients even when receiving maintenance 
      treatment with OCS. In addition, use of OCS is associated with undesirable 
      effects. Despite all this, physicians have continued to use OCS for managing 
      severe asthma and acute exacerbation due to the lack of availability of effective 
      alternatives. Fortunately, in the last decade several biologics have been proven 
      safe and effective for patients with uncontrolled severe asthma. This has led to 
      the Global Initiative for Asthma (GINA) recommending the use of biologics, 
      instead of maintenance OCS, in patients with severe asthma (GINA Step 5). These 
      include one biologic targeting immunoglobulin E (IgE) (omalizumab), and different 
      biologics targeting interleukin-5 (IL-5), the IL-5 receptor (IL-5R) or IL-4 
      receptor alpha-unit (IL-4R alpha), including mepolizumab (subcutaneous), reslizumab 
      (intravenous), benralizumab (subcutaneous) and dupilumab (subcutaneous). 
      Omalizumab for the treatment of severe allergic asthma reduces exacerbations, 
      irrespective of blood eosinophil levels. Anti-IL-5/IL-5R biologics are indicated 
      in patients with severe eosinophilic asthma and repetitive exacerbations, 
      irrespective of the presence or absence of allergy. Recently, an anti-IL4Ralpha 
      biologic has been approved by the FDA for eosinophilic phenotype or oral 
      corticosteroid-dependent asthma. Finally, physicians should consider using 
      biologics as an alternative to chronic OCS therapy.
CI  - Copyright (c) 2019 Elsevier Ltd. All rights reserved.
FAU - Katsaounou, Paraskevi
AU  - Katsaounou P
AD  - School of Medicine, National and Kapodistrian University of Athens, 1st ICU 
      Evangelismos Hospital, Athens, Greece. Electronic address: 
      paraskevikatsaounou@gmail.com.
FAU - Buhl, Roland
AU  - Buhl R
AD  - Pulmonary Department, Mainz University Hospital, Mainz, Germany. Electronic 
      address: roland.buhl@unimedizin-mainz.de.
FAU - Brusselle, Guy
AU  - Brusselle G
AD  - Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan, 
      Ghent, Belgium; Department of Epidemiology and Respiratory Medicine, Erasmus MC 
      Rotterdam, Rotterdam, the Netherlands. Electronic address: 
      guy.brusselle@ugent.be.
FAU - Pfister, Pascal
AU  - Pfister P
AD  - Global Medical Department, Novartis Pharma AG, Basel, Switzerland. Electronic 
      address: pascal.pfister@novartis.com.
FAU - Martinez, Rafael
AU  - Martinez R
AD  - Global Medical Department, Novartis Pharma AG, Basel, Switzerland.
FAU - Wahn, Ulrich
AU  - Wahn U
AD  - Department of Paediatric Pneumology & Immunology, Charite-Universitatsmedizin 
      Berlin, Berlin, Germany. Electronic address: ulrich.wahn@gmail.com.
FAU - Bousquet, Jean
AU  - Bousquet J
AD  - Service des Maladies Respiratoires, Hopital Arnaud de Villeneuve, Montpellier, 
      France. Electronic address: jean.bousquet@orange.fr.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20190207
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Biological Products)
RN  - 0 (IL4R protein, human)
RN  - 0 (IL5 protein, human)
RN  - 0 (Interleukin-4 Receptor alpha Subunit)
RN  - 0 (Interleukin-5)
RN  - 0 (Receptors, Interleukin-5)
RN  - 2P471X1Z11 (Omalizumab)
RN  - 35A26E427H (reslizumab)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 420K487FSG (dupilumab)
RN  - 71492GE1FX (benralizumab)
RN  - 90Z2UF0E52 (mepolizumab)
SB  - IM
MH  - Administration, Intravenous
MH  - Administration, Oral
MH  - Adrenal Cortex Hormones/administration & dosage/*therapeutic use
MH  - Anti-Asthmatic Agents/administration & dosage/therapeutic use
MH  - Antibodies, Monoclonal, Humanized/administration & dosage/*therapeutic use
MH  - Asthma/*drug therapy/epidemiology/immunology/physiopathology
MH  - Biological Products/therapeutic use
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/drug effects
MH  - Injections, Subcutaneous
MH  - Interleukin-4 Receptor alpha Subunit/drug effects
MH  - Interleukin-5
MH  - Male
MH  - Omalizumab/administration & dosage/*therapeutic use
MH  - Receptors, Interleukin-5/drug effects
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Asthma
OT  - Biologics
OT  - Immunoglobulin E/IgE
OT  - Interleukin-5
OT  - Systemic/injectable/oral corticosteroids
EDAT- 2019/04/10 06:00
MHDA- 2020/05/02 06:00
CRDT- 2019/04/10 06:00
PHST- 2018/08/16 00:00 [received]
PHST- 2018/12/21 00:00 [revised]
PHST- 2019/02/04 00:00 [accepted]
PHST- 2019/04/10 06:00 [entrez]
PHST- 2019/04/10 06:00 [pubmed]
PHST- 2020/05/02 06:00 [medline]
AID - S0954-6111(19)30039-3 [pii]
AID - 10.1016/j.rmed.2019.02.003 [doi]
PST - ppublish
SO  - Respir Med. 2019 Apr;150:51-62. doi: 10.1016/j.rmed.2019.02.003. Epub 2019 Feb 7.