[The effectiveness of omalizumab in the control of severe uncontrolled asthma in Latin America. An exploratory systematic review and meta-analysis]

Rev Alerg Mex. 2020 Jan-Mar;67(1):19-24. doi: 10.29262/ram.v67i1.701.
[Article in Spanish]

Abstract

Background: Omalizumab is effective in the treatment of severe persistent allergic asthma that is not controlled with long-acting beta-agonists/ high-dose inhaled corticosteroids.

Objective: To conduct a systematic exploratory review and meta-analysis of studies with omalizumab in Latin America.

Methods: A search of real-life studies on the effectiveness of omalizumab in asthma control conducted in Latin America was carried out. The average of the aggregate effectiveness of omalizumab in asthma control (Pooled Analysis) was estimated by using a random effects model.

Results: Nine open uncontrolled observational studies were identified; these studies included a total of 1 118 patients with severe uncontrolled asthma. The average of the estimated aggregate effectiveness of omalizumab in the good control of severe asthma was of 80.6 % in children and 78.9 % in adults.

Conclusions: The average of the estimated aggregate effectiveness of omalizumab in the control of severe asthma in both children and adults in Latin America was over 78 %. Randomized controlled studies are required in order to establish the efficacy and effectiveness of omalizumab in the control of severe asthma and in the different subgroups by level of eosinophils.

Antecedentes: El omalizumab es eficaz en el tratamiento del asma alérgica persistente grave no controlada con el tratamiento con betaagonistas de acción prolongada/corticoides inhalados en dosis alta. Objetivo: Realizar una revisión sistemática exploratoria y metaanálisis de estudios con omalizumab en Latinoamérica. Métodos: Se realizó una búsqueda de estudios de vida de real realizados en Latinoamérica sobre la efectividad de omalizumab en el control del asma. Se estimó la media de la efectividad agregada del omalizumab en el control del asma, utilizando un modelo de efectos aleatorios. Resultados: Se identificaron nueve estudios observacionales abiertos no controlados, que incluyeron 1118 pacientes con asma grave no controlada. La media de la efectividad agregada estimada del omalizumab en el buen control de asma grave fue de 80.6 %, en los niños fue de 83.4 % y en los adultos de 78.9 %. Conclusiones: La media de la efectividad agregada estimada de omalizumab en el control del asma alérgica grave fue superior a 78 %. Se requieren estudios controlados aleatorizados para establecer la eficacia y efectividad del fármaco en el control de asma grave y en los diferentes subgrupos por nivel de eosinófilos.

Keywords: Asthma control; Omalizumab; Severe asthma.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Humans
  • Latin America
  • Omalizumab / therapeutic use*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Asthmatic Agents
  • Omalizumab