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J Investig Allergol Clin Immunol. 2020;30(1):49-57. doi: 10.18176/jiaci.0391. Epub 2019 Apr 1.

Effectiveness of Omalizumab in Severe Allergic Asthma and Nasal Polyposis: A Real-Life Study.

Author information

1
Department of Pulmonology, University Hospital of Nancy, Nancy, France.
2
EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, University of Lorraine, Nancy, France.
3
Department of Pulmonology, Hospital of Colmar, Colmar, France.
4
Department of Pulmonology, University Hospital of Besançon, Besançon, France.
5
Centre hospitalier universitaire de Nancy, Plateforme d'aide à la recherche clinique, Nancy, France.
6
Department of Pulmonology, Hospital of Metz-Thionville, Thionville, France.
7
Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France.
8
Inserm, LNC UMR866, LipSTIC LabEx team, Dijon, France.
9
Bourgogne Franche-Comté University, Dijon, France.
10
Franche-Comté University, Besançon, France.
11
Department of Pulmonology-Allergology, University Hospital of Strasbourg, Strasbourg, France.
12
University of Strasbourg, Strasbourg, France.

Abstract

BACKGROUND AND OBJECTIVE:

Omalizumab is a human anti-IgE antibody approved for the treatment of severe allergic asthma (SAA). However, its effectiveness in SAA associated with chronic rhinosinusitis with nasal polyposis (CRSNP+) is less well documented. Objective: The aim of this study was to evaluate the real-life effectiveness of omalizumab in patients with SAA and CRSNP+ who tolerated and did not tolerate aspirin.

METHODS:

We performed a retrospective, observational, multicenter, real-life study of patients with SAA and CRSNP+ treated with omalizumab for 6 months. Asthma outcome parameters (symptoms, number of salbutamol rescues/wk, number of moderate/severe exacerbations, Asthma Control Test score, and lung function), sinonasal outcome parameters (symptoms, number of episodes of acute rhinosinusitis, sinus computed tomography images, nasal polyps endoscopy score), and serum eosinophil levels were analyzed 6 months before and after treatment with omalizumab.

RESULTS:

Twenty-four adult patients were included (9 with documented aspirin intolerance). All respiratory parameters were significantly improved by the treatment. In parallel, a significant improvement was observed in sinonasal clinical outcomes and sinus computed tomography images, with no major effect on the nasal polyps endoscopy score. The serum eosinophil count decreased significantly after 6 months of treatment with omalizumab.

CONCLUSION:

Treatment of SAA with omalizumab improves the outcome of associated CRSNP+, thus supporting the concept of a "one airway disease".

KEYWORDS:

CRSNP+; Effectiveness of omalizumab; Severe allergic asthma

PMID:
30931917
DOI:
10.18176/jiaci.0391

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