Journal
JOURNAL OF ASTHMA AND ALLERGY
Volume 5, Issue -, Pages 65-70Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JAA.S34579
Keywords
allergic bronchopulmonary aspergillosis; omalizumab; asthma
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Background: Current therapy for allergic bronchopulmonary aspergillosis 9ABPA) uses oral corticosteroids, exposing patients to the adverse effects of these agents. There are reports of the steroid-sparing effect of anti-IgE therapy with omalizumab for ABPA in patients with cystic fibrosis 9CF), but there is little information on its efficacy against ABPA in patients with bronchial asthma without CF. Objective: To examine the effects of omalizumab, measured by asthma control, blood eosinophilia, total serum immunoglobulin E 9IgE), oral corticosteroid requirements, and forced expiratory volume spirometry in patients with ABPA and bronchial asthma. Methods: A retrospective review of charts from 2004-2006 of patients treated with omalizumab at an academic allergy and immunology practice in the Bronx, New York were examined for systemic steroid and rescue inhaler usage, serum immunoglobulin E levels, blood eosinophil counts, and asthma symptoms, as measured by the Asthma Control Test 9ACT). Results: A total of 21 charts were screened for the diagnosis of ABPA and bronchial asthma. Four patients with ABPA were identified; two of these patients were male. The median monthly systemic corticosteroid use at 6 months and 12 months decreased from baseline usage. Total serum IgE decreased in all patients at 12 months of therapy. Pre-bronchodilator forced expiratory vital capacity at one second 9FEV1) was variable at 1 year of treatment. There was an improvement in Asthma Control Test 9ACT) symptom scores for both daytime and nighttime symptoms. Conclusions: Treatment with omalizumab creates a steroid-sparing effect, reduces systemic inflammatory markers, and results in improvement in ACT scores in patients with ABPA.
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