Omalizumab Effectiveness in Severe Allergic Asthma with Multiple Allergic Comorbidities: A Post-Hoc Analysis of the STELLAIR Study

• Published in: Journal of asthma and allergy Vol. 14; pp. 1129 - 1138
• Main Authors: Just, Jocelyne, Thonnelier, Celine, Bourgoin-Heck, Melisande, Mala, Laurence, Molimard, Mathieu, Humbert, Marc
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2021; Taylor & Francis Ltd; Dove Press; Dove; Dove Medical Press
• Subjects: Advertising executives; Allergic diseases; Analysis; Asthma; Atopic dermatitis; Comorbidity; Conjunctivitis; Dermatitis; Food allergies; Food allergy; Human health and pathology; ig-e; Immunoglobulin E; Life Sciences; Medical research; Medicine, Experimental; Monoclonal antibodies; multiple allergic comorbidities; Omalizumab; Original Research; Patients; Rhinitis; severe allergic asthma; Steroids; France; omalizumab; Ig-E; severe allergic asthma; multiple allergic comorbidities
• ISSN: 1178-6965; 1178-6965
• DOI: 10.2147/JAA.S310888

Immunoglobulin (Ig) E-mediated pathophysiological mechanisms are common in allergic diseases including severe allergic asthma (SAA). The anti-IgE monoclonal antibody omalizumab may be particularly beneficial for patients with SAA and multiple allergic comorbidities (AC) including perennial/seasonal rhinitis, conjunctivitis, atopic dermatitis (AD), and food allergy.
We conducted a post-hoc analysis of the patients from the STELLAIR study (n=872, 149 minors and 723 adults). The patients were classified based on the presence of multiple AC (≥3 AC or <3 AC) or AD as assessed by questionnaire. Response to omalizumab was assessed after 4-6 months (T
) and after 12 months (T
). Asthma response at T
was based on global evaluation of treatment effectiveness, reduction of ≥40% in annual exacerbation rate, and a combination of both. Asthma response at T
was based on change in yearly exacerbation and hospitalization rates. AC improvement at T
was based on patient perception.
Patients with ≥3 AC demonstrated a higher combined response to omalizumab (74.7% vs 58.3%) at T
and had reduced yearly exacerbation and hospitalization rates (88.9% vs 77.4% and -94.0% vs -70.5%, respectively). Patients with ≥3 AC were more likely to show an improvement in their AC (85.3% vs 51.9%) at T
. Results were similar in minors and adults. The presence of AD was associated with greater omalizumab effectiveness at T
and a greater AC improvement at T
. Improvement of AD and food allergies at T
were 73.2% and 38.7%, respectively, in the population overall.
This post-hoc analysis of the STELLAIR study shows that omalizumab is beneficial for all SAA patients and especially for patients with multiple AC or AD. In patients with ≥3 AC, omalizumab also improved AC outcomes.