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Omalizumab effectiveness in patients with severe allergic asthma according to blood eosinophil count: the STELLAIR study

Marc Humbert, Camille Taillé, Laurence Mala, Vincent Le Gros, Jocelyne Just, Mathieu Molimard
European Respiratory Journal 2018; DOI: 10.1183/13993003.02523-2017
Marc Humbert
1Univ. Paris–Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
2AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France
3INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
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Camille Taillé
4AP-HP, Service de Pneumologie, Hôpital Bichat, Paris, France
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Laurence Mala
5Novartis Pharma SAS, Rueil-Malmaison, France
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Vincent Le Gros
5Novartis Pharma SAS, Rueil-Malmaison, France
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Jocelyne Just
6AP-HP, Service de Pneumologie Pédiatrique et Allergologie, Hôpital Trousseau, France
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Mathieu Molimard
7Université de Bordeaux, Department of Medical Pharmacology, Bordeaux, France
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Abstract

Omalizumab is a monoclonal anti-immunoglobulin E antibody used to treat severe allergic asthma (SAA). The aim of the STELLAIR study was to determine the importance of pre-treatment blood eosinophil count (EOS) as a predictive measure for response to omalizumab. This retrospective real-life study was conducted in France between December 2015 and September 2016 using medical records of SAA omalizumab-treated patients. Response to omalizumab was assessed by three criteria: physician evaluation, reduction of ≥40% in annual exacerbation rate, and combination of both. Response rate was calculated according to blood EOS count measured in the year prior to omalizumab initiation. 872 SAA omalizumab-treated patients were included by 78 physicians (723 adults and 149 minors aged 6–17 years). EOS was ≥300/µl in 52.1% of adults and 73.8% of minors. By physician evaluation, 67.2% of adults and 77.2% of minors were responders and 71.1% adults and 78.5% minors had a 40% reduction in exacerbation rate. In adults, response rate for combined criteria was 58.4% (95% CI 53.2–63.4) in EOS ≥300 (n=377) and 58.1% (95% CI 52.7–63.4) in EOS <300 (n=346). This study shows that a large proportion of patients with SAA have EOS ≥300 and suggests that omalizumab effectiveness is similar in high and low EOS subgroups.

Abstract

Omalizumab is a treatment option for severe allergic asthma irrespective of blood eosinophil count

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Humbert reports personal fees from Astrazeneca, personal fees from GSK, personal fees from Novartis, personal fees from Roche, personal fees from TEVA, personal fees from Sanofi/Regeneron, during the conduct of the study.

Conflict of interest: Dr. Taillé reports personal fees from Kappa Santé, during the conduct of the study; personal fees and other from AstraZeneca, personal fees and other from Boeringher, personal fees from Chiesi, grants, personal fees and other from GSK, personal fees and other from Novartis, personal fees from Teva, personal fees and other from ALK, other from Sanofi, outside the submitted work.

Conflict of interest: Dr. Mala reports other from NOVARTIS PHARMA SAS, during the conduct of the study; other from NOVARTIS PHARMA SAS, outside the submitted work.

Conflict of interest: Dr. Le Gros reports other from NOVARTIS PHARMA SAS, during the conduct of the study; other from NOVARTIS PHARMA SAS, outside the submitted work.

Conflict of interest: Dr. just reports personal fees from ALK, personal fees from STALLERGENE, grants and personal fees from NOVARTIS, outside the submitted work.

Conflict of interest: Dr. Molimard reports personal fees from Novartis Pharma, personal fees from GSK, personal fees from Boehringer Ingelheim, personal fees from University of Bordeaux, during the conduct of the study; grants from Novartis Pharma, outside the submitted work .

This is a PDF-only article. Please click on the PDF link above to read it.

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Omalizumab effectiveness in patients with severe allergic asthma according to blood eosinophil count: the STELLAIR study
Marc Humbert, Camille Taillé, Laurence Mala, Vincent Le Gros, Jocelyne Just, Mathieu Molimard
European Respiratory Journal Jan 2018, 1702523; DOI: 10.1183/13993003.02523-2017

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Omalizumab effectiveness in patients with severe allergic asthma according to blood eosinophil count: the STELLAIR study
Marc Humbert, Camille Taillé, Laurence Mala, Vincent Le Gros, Jocelyne Just, Mathieu Molimard
European Respiratory Journal Jan 2018, 1702523; DOI: 10.1183/13993003.02523-2017
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