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      Administración de omalizumab en pacientes mexicanos con diagnóstico de asma moderada a grave no atópica Translated title: Administration of omalizumab in Mexican patients diagnosed with moderate-severe non-atopic asthma.


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          Resumen: OBJETIVO Determinar la mejoría clínica en los pacientes con diagnóstico de asma moderada a severa no atópica en tratamiento con omalizumab. MATERIAL Y MÉTODO estudio prospectivo y observacional en el que del 1 de enero de 2017 al 1 de enero de 2018 se incluyeron pacientes adultos que, a pesar del tratamiento diario con o sin mantenimiento con corticoesteroides orales, tenían asma moderada a severa no atópica descontrolada; los pacientes se asignaron a recibir omalizumab por concentraciones de IgE. El punto final primario fue el cambio en los parámetros clínicos y funcionales de los pacientes por medio de examen de la prueba ACT (Asthma Control Test). RESULTADOS Se incluyeron 20 pacientes. Tras 52 semanas de administración de omalizumab los pacientes mostraron aumento moderado en el FEV1 y mejoría de los parámetros clínicos y funcionales. El alivio sintomático de los pacientes se consideró principalmente con el aumento en la prueba ACT de 10 a 20 puntos. También se observó buena tolerancia al medicamento, sin ningún efecto adverso grave y mejoría en la calidad de vida de los pacientes. CONCLUSIONES Omalizumab tiene un papel terapéutico en el asma no atópica moderada a severa. Nuestros resultados apoyan la eficacia clínica de omalizumab en los pacientes asmáticos no atópicos mexicanos.

          Translated abstract

          Abstract: OBJECTIVE To determine the clinical improvement in patients diagnosed with moderate-severe non-atopic asthma in treatment with omalizumab. MATERIAL AND METHOD A prospective and observational study was made from January 1st 2017 to January 1st 2018 in adult patients who, despite daily treatment with or without maintenance oral corticosteroids, had uncontrolled moderate to severe non-atopic asthma; patients were assigned to receive omalizumab at doses of IgE levels. The primary endpoint was the change in the clinical and functional parameters of the patients by means of Asthma Control Test. RESULTS There were included 20 patients. After 52 weeks of administration of omalizumab they showed a moderate increase in FEV1 and in clinical and functional parameters. The symptomatic improvement of the patients was mainly considered by an increase of 10 to 20 points in Asthma Control Test. Good tolerance to the drug was also observed, without any serious adverse effects, as well as improvement in the quality of life of the patients. CONCLUSIONS Omalizumab has a therapeutic role in moderate to severe non-atopic asthma. Our results support the clinical efficacy of omalizumab in Mexican non-atopic asthmatic patients.

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          Most cited references22

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          Association of asthma with serum IgE levels and skin-test reactivity to allergens.

          We investigated the association of self-reported asthma or allergic rhinitis with serum IgE levels and skin-test reactivity to allergens in 2657 subjects in a general-population study. Regardless of the subjects' status with respect to atopy or their age group, the prevalence of asthma was closely related to the serum IgE level standardized for age and sex (P less than 0.0001), and no asthma was present in the 177 subjects with the lowest IgE levels for their age and sex (greater than 1.46 SD below the mean). The log odds ratio increased linearly with the serum IgE level after we controlled for possible confounders and the degree of reactivity to skin tests. In contrast, allergic rhinitis appeared to be associated primarily with skin-test reactions to common aeroallergens, independently of the serum IgE level. We conclude that asthma is almost always associated with some type of IgE-related reaction and therefore has an allergic basis, although not all the allergic stimuli that cause asthma appear to have been included in the battery of common aeroallergens we used to assess atopic status. These findings challenge the concept that there are basic differences between so-called allergic ("extrinsic") and nonallergic ("intrinsic") forms of asthma.
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            A proof-of-concept, randomized, controlled trial of omalizumab in patients with severe, difficult-to-control, nonatopic asthma.

            While up to 50% of patients with severe asthma have no evidence of allergy, IgE has been linked to asthma, irrespective of atopic status. Omalizumab, an anti-IgE monoclonal antibody, is reported to significantly benefit a subset of patients with severe, persistent, allergic asthma. Therefore, we investigated whether omalizumab has biologic and clinical effects in patients with refractory nonatopic asthma.
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              The immunopathology of extrinsic (atopic) and intrinsic (non-atopic) asthma: more similarities than differences.


                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Medicina interna de México
                Med. interna Méx.
                Edición y Farmacia S.A. de C.V. (Ciudad de México, Ciudad de México, Mexico )
                December 2018
                : 34
                : 6
                : 833-839
                [1] Puebla orgnameHospital Universitario de Puebla orgdiv1Clínica de Asma y EPOC México
                [3] orgnameBenemérita Universidad Autónoma de Puebla orgdiv1Departamento de Pregrado Mexico
                [2] Puebla orgnameHospital Universitario de Puebla orgdiv1Departamento de Neumología México

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                : 15 March 2018
                : June 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 7

                SciELO Mexico

                Artículos originales

                Quality of life,Asma,omalizumab,calidad de vida,Omalizumab,Asthma


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