Utility of serum periostin and free IgE levels in evaluating responsiveness to omalizumab in patients with severe asthma.
Omalizumab, a humanized anti-IgE monoclonal antibody, has demonstrated efficacy in patients with severe allergic asthma. However, treatment responses vary widely among individuals. Despite a lack of data, free serum IgE levels following omalizumab treatment have been proposed as a marker of treatment responsiveness.



In this prospective, observational study, we assessed the utility of biomarkers of type 2 inflammation in predicting omalizumab treatment responses, as determined by the absence of asthma exacerbation during the first year of treatment. Free serum IgE levels were monitored for 2 years to examine their association with baseline biomarker levels and the number of exacerbations.



We enrolled thirty patients who had been treated with omalizumab for at least 1 year, of whom 27 were treated for 2 years. Baseline serum periostin levels and blood eosinophil counts were significantly higher in patients without exacerbations during the first year of treatment than in patients with exacerbations. Baseline serum periostin levels, but not eosinophil counts, were negatively associated with free serum IgE levels after 16 or 32 weeks of treatment. Reduced free serum IgE levels during treatment from those at baseline were associated with reduced exacerbation numbers at 2 years. In 14 patients who continued to have exacerbations during the first year of treatment, exacerbation numbers gradually and significantly decreased over the 2-year study period, with concurrent significant reductions in free serum IgE levels.



Baseline serum periostin levels and serum free IgE levels during treatment follow-up may be useful in evaluating responses to omalizumab treatment.
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
T
T
Tajiri
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. hmatsumo@kuhp.kyoto-u.ac.jp.
H
H
Matsumoto
Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Y
Y
Gon
Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
R
R
Ito
Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
S
S
Hashimoto
Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan.
K
K
Izuhara
Respiratory Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
M
M
Suzukawa
Respiratory Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
K
K
Ohta
Shino-Test Corporation, Kanagawa, Japan.
J
J
Ono
Department of Laboratory Medicine, Saga Medical School, Saga, Japan.
S
S
Ohta
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
I
I
Ito
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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T
Oguma
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
H
H
Inoue
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
T
T
Iwata
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Y
Y
Kanemitsu
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
T
T
Nagasaki
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Division of Respiratory Medicine, Department of Medical Oncology and Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan.
A
A
Niimi
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
M
M
Mishima
D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D015415:Biomarkers; D015815:Cell Adhesion Molecules / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000494:pharmacology / Q000627:therapeutic use*; D012372:ROC Curve; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D015815:Cell Adhesion Molecules; C512835:POSTN protein, human; D000069444:Omalizumab; D007073:Immunoglobulin E
asthma; omalizumab; periostin; serum free IgE; treatment responsiveness