Presented at the European Respiratory Society (ERS) congress in Amsterdam were the initial results from the APEX (Asthma Patient Experience on Xoliar) investigation. The results verify that Xolair® (omalizumab) considerably reduces patients need for steroid use, while at the same time managing disease control and lowering the amount of asthma exacerbations.

In the investigation the researchers discovered that omalizumab helps individuals reduce the use of oral steroids; which despite being an effective treatment for patients with severe asthma they are connected with long-term adverse effects, such as weight gain, hypertension, osteoporosis and depression. In the 12 months after patients started on omalizumab (p<0.001), the mean total dose of oral corticosteroids per individual reduced by 34%, with 49% of individuals stopping the oral steroids altogether and 64% considerably reducing their oral corticosteroid dosage. For individuals that suffer with severe, persistent allergic asthma, omalizumab provides a new method for treating patients by targeting the immunoglobulim, IgE, a root cause of the symptoms of allergic asthma. This new steroid-free treatment is providing alternatives for individuals suffering with this condition who rely strongly on either maintenance steroids or frequent steroid bursts. The investigation revealed that in comparison to the one year prior to taking omalizumab, patients experienced a considerable reduction in the amount of asthma exacerbations after 12 months of treatment (53%, 1.7 versus 3.7, 95% CI, p<0.001). And results also revealed an improvement in lung function. Professor Neil Barnes, Consultant Respiratory Physician at London Chest Hospital, Bart’s and at the London Trust and School of Medicine and Dentistry and the chief researcher of the APEX investigation, explained:

“Despite optimal treatment there are a significant minority of patients with asthma who require oral steroid tablets, either every day or have frequent bursts of high-dose treatment. The data from the APEX Study, the first study of Xolair’s use in current clinical practice, shows that with this treatment a percentage of these patient can either reduce of eliminate their requirement for oral steroids with all their undesirable side effects.”

In the UK, roughly a quarter of a million individuals suffer from severe asthma and are the heaviest users of health care services. Approximately 80% of the costs for treating patients with asthma is spent on those with the severest symptoms. A smaller group of these individuals will have allergic type asthma, when exposed to allergans, causes an inflammatory response and bronchoconstriction.

The use of healthcare resources were also reduced with the use of omalizumab. Results revealed that the number of accident/emergency visits (70%, 1.5 vs 0.5, 95% CI, p<0.001) and hospitalizations (61%, 1.3 vs 0.5, 95% CI, p<0.001) were considerably lower in the year following treatment with omalizumab. Furthermore, in the overall patient population (n=136) the total length of hospital stays were reduced by 6.1 days and 11 days in the subgroup of hospitalized individuals (n=81), after 12 months of treatment with omalizumab. Dr Rob Niven, senior lecturer in Respiratory Medicine at the University Hospital of South Manchester said:

“People with severe forms of asthma live in constant fear of the next potentially fatal asthma attack for most of their lives, impacting on education, relationships, work, mental health and overall quality of life. Any research that supports another treatment option, that not only reduces the side effect burden of steroids, but also minimizes the risk of asthma attacks, is extremely encouraging news.”

Similar benefits were observed in individuals on omalizumab who were not receiving continuous oral corticosteroids (n=46) in comparison to individuals who were receiving continuous oral corticosteroids at baseline (n=90).

Written by Grace Rattue