Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Wei-Chang Huang; Pin-Kuei Fu; Ming-Cheng Chan; Chun-Shih Chin; Wen-Nan Huang; Kuo-Lung Lai; Jiun-Long Wang; Wei-Ting Hung; Yi-Da Wu; Chia-Wei Hsieh; Ming-Feng Wu; Yi-Hsing Chen; Jeng-Yuan Hsu

doi:10.3389/fmed.2021.762318

Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Front Med (Lausanne). 2022 Jan 3:8:762318. doi: 10.3389/fmed.2021.762318. eCollection 2021.

Authors

Wei-Chang Huang^{1

2

3

4

5

6}, Pin-Kuei Fu^{7

8

9}, Ming-Cheng Chan^{2

10}, Chun-Shih Chin¹, Wen-Nan Huang^{2

11}, Kuo-Lung Lai¹¹, Jiun-Long Wang^{1

3

12

13}, Wei-Ting Hung¹¹, Yi-Da Wu¹¹, Chia-Wei Hsieh^{3

11}, Ming-Feng Wu^{1

14}, Yi-Hsing Chen^{11

15}, Jeng-Yuan Hsu^{16

17}

Affiliations

¹ Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
² College of Medicine, National Chung Hsing University, Taichung, Taiwan.
³ Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
⁴ School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁵ Master Program for Health Administration, Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.
⁶ Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
⁷ Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
⁸ College of Human Science and Social Innovation, Hungkuang University, Taichung, Taiwan.
⁹ Department of Computer Science, Tunghai University, Taichung, Taiwan.
¹⁰ Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
¹¹ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
¹² Agricultural Biotechnology Research Center, National Chung Hsing University, Taichung, Taiwan.
¹³ Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan.
¹⁴ Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
¹⁵ School of Medicine, National Yang Ming Chia Tung University, Taipei, Taiwan.
¹⁶ Division of Clinical Research, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
¹⁷ School of Physical Therapy, Chung-Shan Medical University, Taichung, Taiwan.

Abstract

Several factors have been found to be predictors of a good response following omalizumab treatment in patients with severe allergic asthma (SAA). However, it remains unclear whether clinical characteristics can predict a minimal clinically important difference (MCID) following omalizumab treatment in this population. Therefore, the aim of this study was to investigate the features associated with an MCID following omalizumab treatment in adult patients with SAA. Of the 124 participants enrolled in this retrospective, cross-sectional study, 94, 103, 20 and 53 achieved the MCID following treatment with omalizumab and were considered to be responders of exacerbation reduction (no exacerbation during the 1-year follow-up period or ≧50% reduction in exacerbations from baseline), oral corticosteroid (OCS) sparing (no use of OCS to control asthma during the study period or a reduction of the monthly OCS maintenance dose to <50% of baseline), lung function (an increase of ≧230 ml in the forced expiratory volume in 1 s from baseline) and asthma control (an increase of ≧3 points in the asthma control test score from baseline), respectively. Normal weight [<25 vs. ≧30 kg/m², odds ratio (OR) = 3.86, p = 0.024] was predictive of a responder of reduction in exacerbations following omalizumab treatment while subjects with a blood eosinophil level of <300 cells/μL (<300 vs. ≧300 cells/μL, OR = 5.81, p = 0.001) were more likely to exhibit an MCID in OCS sparing. No factor was found to be a predictor of lung function or asthma control. When choosing treatment for adult patients with SAA, our findings may help to select those who may benefit the most from omalizumab treatment.

Keywords: anti-IgE; asthma; minimal clinically important difference (MCID); omalizumab; predictor.