***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND In a 1-year , r and omized , open-label study in patients with moderate-to-severe allergic ( immunoglobulin E (IgE)-mediated ) asthma , adding omalizumab to best st and ard care ( BSC ) significantly improved efficacy outcomes compared with BSC alone ( control ) . We assessed the efficacy of omalizumab in the subgroup of patients with inadequately controlled severe persistent allergic asthma despite high-dose inhaled corticosteroids ( ICS ) plus a long-acting beta(2)-agonist ( LABA ) , which reflects the European Union ( EU ) label population . METHODS Efficacy outcomes included annual asthma exacerbation rate , annual asthma deterioration-related incident ( ADRI ) rate , % predicted forced expiratory volume in 1 s ( FEV(1 ) ) , asthma symptoms ( Wasserfallen score ) and quality of life ( Mini Asthma Quality of Life Question naire ( Mini-AQLQ ) ) , which were compared in the omalizumab and control groups . Outcomes were also determined for omalizumab-treated patients judged to have responded to therapy ( > or = 0.5-point improvement in Mini-AQLQ overall score at 27 weeks ) . RESULTS In total , 164 patients ( omalizumab , n=115 ; control , n=49 ) were receiving high-dose ICS plus a LABA .  Annual asthma exacerbation rate was significantly reduced by 59 % in the omalizumab group vs. control ( 1.26 vs. 3.06 ; P<0.001 ) . ADRI rate was significantly reduced by 40 % in the omalizumab group compared with control ( 5.61 vs. 9.40 ; P<0.05 ) . Significant improvements were also seen in % predicted FEV(1 ) ( 71 % vs. 60 % ; P<0.001 ) , change from baseline in asthma symptom scores ( -6.7 vs. 0.5 ; P<0.05 ) and Mini-AQLQ overall score ( 1.32 vs. 0.17 ; P<0.001 ) . In omalizumab-treated patients , 71/102 ( 70 % ) were judged to have responded to therapy . In these Mini-AQLQ-assessed responders , exacerbation rate was reduced by 64 % vs. control ( 1.12 vs. 3.06 ; P<0.001 ) , ADRI rate was reduced by 50 % vs. control ( 4.71 vs. 9.40 ; P<0.01 ) . Percent predicted FEV(1 ) ( 73 % vs. 60 % ; P<0.001 ) , change from baseline in asthma symptom scores ( -8.1 vs. 0.5 ; P<0.001 ) and Mini-AQLQ overall score ( 1.81 vs. 0.17 ; P<0.001 ) were also further significantly improved vs. control . CONCLUSIONS Adding omalizumab to BSC is efficacious in patients with inadequately controlled severe persistent allergic asthma despite high-dose ICS plus a LABA ( EU label population ) , with further efficacy observed in patients judged to have responded to therapy which may more accurately illustrate the actual benefit of omalizumab therapy in clinical practice . The naturalistic setting of this study confirms the benefits observed in double-blind r and omized clinical trials Background : Omalizumab may inhibit allergic inflammation and could contribute to decreasing airway remodeling in patients with asthma . Objective : The aim of this study was to assess the effects of omalizumab on airway wall thickness using computed tomography ( CT ) . Methods : Thirty patients with severe persistent asthma were r and omized to conventional therapy with ( n = 14 ) or without omalizumab ( n = 16 ) for 16 weeks . The following airway dimensions were assessed by a vali date d CT technique : airway wall area corrected for body surface area ( WA/BSA ) , percentage wall area ( WA% ) , wall thickness (T)/√BSA , and luminal area (Ai)/BSA at the right apical segmental bronchus . The percentage of eosinophils in induced sputum , pulmonary function and the Asthma Quality of Life Question naire ( AQLQ ) were assessed as well . Results : Treatment with omalizumab significantly decreased WA/BSA ( p < 0.01 ) , WA% ( p < 0.01 ) , and T/√BSA ( p < 0.01 ) , and increased Ai/BSA ( p < 0.05 ) , whereas conventional therapy result ed in no change . In the omalizumab group ( n = 14 ) , a significant decrease in the percentage of sputum eosinophils ( p < 0.01 ) , improved forced expiratory volume in 1 s ( FEV1 ) , and an improved AQLQ score were recorded . The changes in FEV1 % predicted and sputum eosinophils were significantly correlated with changes in WA% ( r = 0.88 , p < 0.001 , and r = 072 , p < 0.01 , respectively ) . Conclusions : These findings suggest that omalizumab  reduced airway wall thickness and airway inflammation . Larger patient studies with longer-term follow-up are needed to show whether omalizumab can truly maintain improved airway wall dimensions The aim of the present study was to determine the effect of treatment with omalizumab , an anti-immunoglobulin E antibody , on asthma-related quality of life ( AQoL ) in patients with moderate-to-severe allergic asthma . A total of 546 patients with allergic asthma were r and omised to double-blind subcutaneous treatment with either placebo or omalizumab for 52 weeks . A constant beclomethasone dipropionate dose was maintained during the first 16 weeks ( steroid-stable phase ) . This was followed by a 12-week steroid-reduction phase . The core study was followed by a 24-week double-blind extension phase . AQoL was evaluated at baseline and at the end of the steroid-stable ( week 16 ) , steroid-reduction ( week 28 ) and extension phases ( week 52 ) using the Juniper Asthma Quality of Life Question naire ( AQLQ ) . Baseline AQLQ scores were comparable for the two treatment groups . Relative to placebo , omalizumab-treated patients demonstrated statistically significant improvements from baseline across all four AQLQ domains , as well as overall AQoL score , at weeks 16 ( except environmental exposure ) , 28 and 52 . Patients on omalizumab were also more likely to achieve clinical ly significant improvements in AQoL during the course of the study . Overall , almost 70 % of patients and investigators rated treatment with omalizumab as “ excellent/good ” , compared with ∼40 % of placebo recipients . Clinical studies show that omalizumab  enhances disease control whilst reducing corticosteroid consumption in patients with allergic asthma . The results of the present study show that these changes are paralleled by improvements in asthma-related quality of life that are meaningful to such patients Background : Anti‐IgE therapy could be particularly beneficial for patients with concomitant disease as it targets a common factor in both diseases . The aim of this study was to evaluate the efficacy and safety of omalizumab in patients with concomitant moderate‐to‐severe asthma and persistent allergic rhinitis The clinical benefit and steroid-sparing effect of treatment with the anti-immunoglobulin-E ( IgE ) antibody , omalizumab , was assessed in patients with moderate-to-severe allergic asthma . After a run-in period , 546 allergic asthmatics ( aged 12 - 76 yrs ) , symptomatic despite inhaled corticosteroids ( 500 - 1,200 microg daily of beclomethasone dipropionate )  , were r and omized to receive double-blind either placebo or omalizumab every 2 or 4 weeks ( depending on body weight and serum total IgE ) subcutaneously for 7 months . A constant beclomethasone dose was maintained during a 16-week stable-steroid phase and progressively reduced to the lowest dose required for asthma control over the following 8 weeks . The latter dose was maintained for the next 4 weeks . Asthma exacerbations represented the primary variable . Compared to the placebo group , the omalizumab group showed 58 % fewer exacerbations per patient during the stable-steroid phase ( p<0.001 ) . During the steroid-reduction phase , there were 52 % fewer exacerbations in the omalizumab group versus the placebo group ( p<0.001 ) despite the greater reduction of the beclomethasone dosage on omalizumab ( p<0.001 ) . Treatment with omalizumab was well tolerated . The incidence of adverse events was similar in both groups . These results indicate that omalizumab therapy safely improves asthma control in allergic asthmatics who remain symptomatic despite regular use of inhaled corticosteroids and simultaneous reduction in corticosteroid requirement BACKGROUND Treatment decisions in asthma are based on assessment s of symptoms and simple measures of lung function , which do not relate closely to underlying eosinophilic airway inflammation . We aim ed to assess whether a management strategy that minimises eosinophilic inflammation reduces asthma exacerbations compared with a st and ard management strategy . METHODS We recruited 74 patients with moderate to severe asthma from hospital clinics and r and omly allocated them to management either by st and ard British Thoracic Society asthma guidelines ( BTS management group ) or by normalisation of the induced sputum eosinophil count and reduction of symptoms ( sputum management group ) . We assessed patients nine times over 12 months . The results were used to manage those in the sputum management group , but were not disclosed in the BTS group . The primary outcomes were the number of severe exacerbations and control of eosinophilic inflammation , measured by induced sputum eosinophil count . Analyses were by intention to treat . FINDINGS The sputum eosinophil count was 63 % ( 95 % CI 24 - 100 ) lower over 12 months in the sputum management group than in the BTS management group ( p=0.002 ) . Patients in the sputum management group had significantly fewer severe asthma exacerbations than did patients in the BTS management group ( 35 vs 109 ; p=0.01 ) and significantly fewer patients were admitted to hospital with asthma ( one vs six , p=0.047 ) . The average daily dose of inhaled or oral corticosteroids did not differ between the two groups . INTERPRETATION A treatment strategy directed at normalisation of the induced sputum eosinophil count reduces asthma exacerbations and admissions without the need for additional anti-inflammatory treatment RATIONALE Accumulation of eosinophils in the bronchial mucosa of individuals with asthma is considered to be a central event in the pathogenesis of asthma . In animal models , airway eosinophil recruitment and airway hyperresponsiveness in response to allergen challenge are reduced by specific targeting of interleukin-5 . A previous small dose-finding study found that mepolizumab , a humanized anti-interleukin-5 monoclonal antibody , had no effect on allergen challenge in humans . OBJECTIVES To investigate the effect of three intravenous infusions of mepolizumab , 250 or 750 mg at monthly intervals , on clinical outcome measures in 362 patients with asthma experiencing persistent symptoms despite inhaled corticosteroid therapy ( 400 - 1,000 mug of beclomethasone or equivalent ) . METHODS Multicenter , r and omized , double-blind , placebo-controlled study . MEASUREMENTS AND MAIN RESULTS Morning peak expiratory flow , forced expiratory volume in 1 second , daily beta(2)-agonist use , symptom scores , exacerbation rates , and quality of life measures . Sputum eosinophil levels were also measured in a subgroup of 37 individuals . Mepolizumab was associated with a significant reduction in blood and sputum eosinophils in both treatment groups ( blood , P < 0.001 for both doses ; sputum , P = 0.006 for 250 mg and P = 0.004 for 750 mg ) . There were no statistically significant changes in any of the clinical end points measured . There was a nonsignificant trend for decrease in exacerbation rates in the mepolizumab 750-mg treatment group ( P = 0.065 ) . CONCLUSIONS Mepolizumab treatment does not appear to add significant clinical benefit in patients with asthma with persistent symptoms despite inhaled corticosteroid therapy . Further studies are needed to investigate the effect of mepolizumab on exacerbation rates , using protocol s specifically tailored to patients with asthma with persistent airway eosinophilia BACKGROUND A recombinant humanized anti-IgE mAb , omalizumab , forms complexes with free IgE , blocking its interaction with mast cells and basophils ; as a consequence , it might be effective in the treatment of asthma . OBJECTIVE The purpose of this study was to evaluate the efficacy and safety of omalizumab in the treatment of inhaled 
    Output:
    
Both medications were successful in reducing the calculated annualized rates of asthma exacerbations ( AEs ) vs placebo by approximately 50 % .
When compared indirectly via a network meta- analysis , the efficacy of OMA and Mepo was similar in the treatment of asthma that was not well controlled on at least high-dose ICS .
The high heterogeneity observed and the different selection criteria for the use of the two drugs do not permit us to make any definitive recommendations for the preferential use of OMA vs Mepo in the patient population s studied .
However , the current data do not suggest any major differences in efficacy