Effects of omalizumab in allergic bronchopulmonary aspergillosis in 10 asthmatic patients

Author:

Lise Melscoet, Naji Khayath, Frederic De Blay

Author address:

France

Abstract:

Background
Treatment for allergic bronchopulmonary aspergillosis (ABPA) involves oral corticosteroids, but adverse effects commonly occur. Case reports have reported omalizumab (monoclonal antibody anti-IgE) effectiveness in ABPA, particularly in steroid-sparing effect. The aim of the study was to assess response to omalizumab in patients with ABPA.

Method
This retrospective and real-life study was performed in Chest Diseases Department at Strasbourg University Hospitals, from January 1, 2006 to June 30, 2017. The response to omalizumab treatment was assessed at 6 (T6) and 12 months (T12) compared with data collected at the omalizumab initiation (T0) and using 4 criteria : reduction in asthma exacerbation rate, decrease in oral corticosteroids use, improvement in asthma control (according to GINA 2018) and pulmonary function.

Results
Ten patients were included. At T0, the median number of exacerbations in the year prior to omalizumab was 5,5 [0-13], 80% of patients were treated with oral corticosteroids and none of the patients were controlled. After 6 months of treatment, the annual exacerbation rate was 2 [0-14], oral corticosteroids were stopped in 5/8 (62,5%) of patients and asthma control was achieved in 5/10 (50%) of patients. However, between the 6th and 12th month, 60% of patients stopped omalizumab due to lack of asthma control. Among the 40% of patients who were still being treated with omalizumab at T12 : asthma control was achieved in 100% of cases, the annual exacerbation rate was zero and none of the patients were treated with oral corticosteroids at T6 and T12. 

Conclusion
Omalizumab resulted in a steroid-sparing effect in ABPA, with a reduction in severe exacerbations and oral corticosteroids use.   

Abstract Number: 1246

Conference Year: 2020

Link Conference abstract: 

EAACI 2020

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