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Journal Information
Vol. 42. Issue S1.
Pages 32-36 (May 2006)
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Vol. 42. Issue S1.
Pages 32-36 (May 2006)
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Utilidad clínica del omalizumab
Clinical utility of omalizumab
Visits
10820
Carlos Villasante Fernández-Montesa
a Servicio de Neumología. Hospital Universitario La Paz. Madrid. España.
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Article information
Omalizumab es un anticuerpo monoclonal humanizado anti-IgE que ha demostrado efectos clínicos en pacientes con asma y rinitis alérgicas. El tratamiento escalonado del asma se realiza con fármacos antiinflamatorios, fundamentalmente corticoides inhalados, a los que se añaden otros tratamientos para conseguir el mayor grado posible de control de la enfermedad. En algunos pacientes no es posible conseguir un control aceptable a pesar del tratamiento con dosis altas de corticoides inhalados, incluso con corticoides por vía oral. Diversos ensayos clínicos han demostrado que la terapia con omalizumab consigue mejorar el grado de control en estos casos reduciendo el número de agudizaciones y las visitas a urgencias. Así mismo, es posible dismiunuir la dosis de corticoides requeridas. El porcentaje de enfermos que responden al tratamiento con omalizumab es mayor entre los que tienen mas riesgo de morbilidad y mortalidad. Los pacientes que presentan simultáneamente asma alérgica mal controlada y rinitis alérgica se benefician en ambos procesos del tratamiento con omalizumab. Las últimas ediciones de las guías y recomendaciones del manejo del asma ya mencionan la posible indicación como terapia añadida en asma alérgica de control difícil.
Palabras clave:
Omalizumab
Terapia anti IgE
Asma grave persistente
Asma de control difícil
Rinitis alérgica
Omalizumab is a humanized monoclonal anti-IgE antibody with demonstrated clinical effects in patients with allergic asthma and rhinitis. Escalation therapy for asthma is carried out with antiinflammatory drugs, mainly inhaled steroids, together with other treatments that are added to achieve the best possible control of the disease. In some patients, acceptable control cannot be achieved despite high-dose inhaled steroids, even oral steroids. Several clinical trials have demonstrated that omalizumab therapy achieves better control in these patients, reducing the number of acute exacerbations and visits to the emergency department. Likewise, the steroid dose required can be reduced. The percentage of patients that respond to omalizumab therapy is greater among those with the highest risk of morbidity and mortality. In patients who simultaneously present poorly controlled allergic asthma and allergic rhinitis, the drug improves both processes. The latest guidelines and recommendations for the management of asthma already mention its possible indication as additional therapy in difficult to control allergic asthma.
Keywords:
Omalizumab
Anti IgE therapy
Severe asthma
Difficult asthma
Allergic rhinitis
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