Omalizumab is an efficient drug for patients with uncontrolled severe allergic asthma (SAA). However, little is known about the differences in omalizumab treatment outcomes among patients with different types of atopic sensitization. Here, we assessed the effect of sensitization to individual allergens or their combinations on the outcomes of anti-IgE therapy in patients with SAA. We performed a post hoc analysis of data of subgroups of patients enrolled in the Czech Anti-IgE Registry (CAR). The patients were evaluated at baseline and 16 weeks and 12 months after omalizumab treatment initiation. We analyzed the dependence of primary treatment outcomes [global evaluation of treatment effectiveness (GETE) after 16 weeks of treatment, a reduction in severe exacerbation rate (ER), and an improvement in the asthma control test (ACT) result during 12 months of treatment] and secondary outcomes [a reduction in systemic corticosteroid (SCS) use, an improvement in lung functions, and a fraction of exhaled nitric oxide] of patients with SAA treated with omalizumab for 12 months on sensitization to different perennial aeroallergens. We assessed sensitization to house dust mites, molds, and pets at baseline using skin prick tests and/or specific IgE measurement (semiquantitative evaluation). We compared polysensitized patients (sensitized to all tested allergens) with monosensitized (single positivity) or partially polysensitized patients (combined positivity but not to all allergens). We enrolled 279 patients (58.3% women, mean age 52.9 years). Omalizumab treatment presented an 82.8% response rate (according to GETE). It significantly reduced severe asthma exacerbations and SCS use, and improved the ACT result in 161 responders. We identified a subgroup of responders with distinct sensitization patterns (polysensitization to all tested perennial allergens) with higher odds of being responders (OR = 2.217, p = 0.02) and lower tendency to improve ACT result (OR 0.398, p = 0.023) and reduce ER (OR 0.431, p = 0.034) than non-polysensitized patients. The clinical benefit of sensitization for patients with SAA receiving omalizumab may be particularly dependent on sensitization pattern. Polysensitized patients showed a higher tendency to be responders (GETE), but a lower tendency to improve the ACT result and reduce ER than non-polysensitized patients.

中文翻译：

---

使用捷克抗 IgE 登记处的数据确定个体过敏原致敏对严重过敏性哮喘患者奥马珠单抗治疗结果的影响。

奥马珠单抗是一种有效的药物，可用于无法控制的严重过敏性哮喘（SAA）患者。然而，对于不同类型的特应性致敏患者之间奥马珠单抗治疗结果的差异知之甚少。在这里，我们评估了对单个过敏原或其组合的敏感性对 SAA 患者抗 IgE 治疗结果的影响。我们对捷克抗 IgE 登记处 (CAR) 中登记的患者亚组数据进行了事后分析。在基线和奥马珠单抗治疗开始后 16 周和 12 个月对患者进行评估。我们分析了主要治疗结果的依赖性[治疗 16 周后治疗效果的全球评估 (GETE)、严重恶化率 (ER) 的降低、SAA 患者在 12 个月的治疗期间哮喘控制测试 (ACT) 结果得到改善] 和次要结果 [全身性皮质类固醇 (SCS) 使用减少、肺功能改善和呼出气一氧化氮的一部分]奥马珠单抗治疗 12 个月，对不同的常年气性过敏原敏感。我们使用皮肤点刺测试和/或特异性 IgE 测量（半定量评估）在基线评估了对屋尘螨、霉菌和宠物的敏感性。我们比较了多敏患者（对所有测试的过敏原敏感）与单敏（单一阳性）或部分多敏患者（组合阳性但不是对所有过敏原）。我们招募了 279 名患者（58.3% 为女性，平均年龄 52.9 岁）。奥马珠单抗治疗的反应率为 82.8%（根据 GETE）。它显着减少了严重的哮喘发作和 SCS 的使用，并改善了 161 名反应者的 ACT 结果。我们确定了一个具有不同致敏模式（对所有测试的常年过敏原多敏化）的响应者亚组，其成为响应者的几率更高（OR = 2.217，p = 0.02）和改善 ACT 结果的趋势较低（OR 0.398，p = 0.023）并减少ER (OR 0.431, p = 0.034) 高于非多敏患者。对接受奥马珠单抗的 SAA 患者进行致敏的临床益处可能特别取决于致敏模式。与非多敏患者相比，多敏患者表现出更高的反应倾向（GETE），但改善ACT结果和降低ER的趋势较低。我们确定了一个具有不同致敏模式（对所有测试的常年过敏原多敏化）的响应者亚组，其成为响应者的几率更高（OR = 2.217，p = 0.02）和改善 ACT 结果的趋势较低（OR 0.398，p = 0.023）并减少ER (OR 0.431, p = 0.034) 高于非多敏患者。对接受奥马珠单抗的 SAA 患者进行致敏的临床益处可能特别取决于致敏模式。与非多敏患者相比，多敏患者表现出更高的反应倾向（GETE），但改善ACT结果和降低ER的趋势较低。我们确定了一个具有不同致敏模式（对所有测试的常年过敏原多敏化）的响应者亚组，其成为响应者的几率更高（OR = 2.217，p = 0.02）和改善 ACT 结果的趋势较低（OR 0.398，p = 0.023）并减少ER (OR 0.431, p = 0.034) 高于非多敏患者。对接受奥马珠单抗的 SAA 患者进行致敏的临床益处可能特别取决于致敏模式。与非多敏患者相比，多敏患者表现出更高的反应倾向（GETE），但改善ACT结果和降低ER的趋势较低。023) 和减少 ER (OR 0.431, p = 0.034) 比非多敏患者。对接受奥马珠单抗的 SAA 患者进行致敏的临床益处可能特别取决于致敏模式。与非多敏患者相比，多敏患者表现出更高的反应倾向（GETE），但改善ACT结果和降低ER的趋势较低。023) 和减少 ER (OR 0.431, p = 0.034) 比非多敏患者。对接受奥马珠单抗的 SAA 患者进行致敏的临床益处可能特别取决于致敏模式。与非多敏患者相比，多敏患者表现出更高的反应倾向（GETE），但改善ACT结果和降低ER的趋势较低。