Omalizumab in the treatment of allergic bronchopulmonary aspergillosis: One center's experience with 14 cases

Abstract

Omalizumab provided a clinically important reduction in exacerbations and steroid requirement, and improved asthma symptoms and pulmonary function parameters in patients with asthma and ABPA who had previously shown an unsatisfactory response to Global Initiative for Asthma step 4 treatment.

Allergic Bronchopulmonary Aspergillosis: A Clinical Evaluation of 15 Patients and Successful Omalizumab Treatment of Five Patients

“…Collins et al observed a significant improvement in ACT symptom scores in patients with ABPA after omalizumab treatment (30). Aydın et al reported that compared to the basal score, mean ACT score had increased after starting omalizumab treatment (21). Similar to these two reports, omalizumab treatment improved asthma symptoms and significantly increased the mean ACT score in both the first and third years in our study.…”

“…Patients who do not respond to corticosteroids antifungal medication can be used (29). Recently, reports have described effective results with the administration of omalizumab in patients with severe allergic asthma and ABPA (21,29). In our study 5 (33.3%) patients with severe asthma had unsatisfactory response to anti-asthmatic agents.…”

“…ABPA is an immunological pulmonary disorder with various clinical, radiological and laboratory features (2) . Published reports about ABPA are limited to case reports and small series in our country (21,23). This is perhaps due to lack of uniform diagnostic criteria.…”

“…These patients were followed at 3 months intervals. We considered omalizumab treatment in severe persistent asthma and ABPA patients who have failed to respond to Global Initiative for Asthma step 4 treatment (21). Omalizumab was administered at dosages and dosing frequency based on the patient's weight and initial total IgE levels as recommended for asthma (22).…”

Asthma, allergy, and psychiatric disease

“…They indicate that the serum EDN level may be a useful marker for monitoring persistent airflow limitation in adult patients with allergic asthma who are positive for house-dust-specific IgE antibodies. Also within this issue, Aydın et al 3 report on the potential utility of total serum IgE as a biomarker for responsiveness to omalizumab in patients with allergic bronchopulmonary aspergillosis.…”