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Revista Portuguesa de Imunoalergologia

Print version ISSN 0871-9721


DIAS, José Geraldo et al. Omalizumab in the treatment of allergic asthma: Experience in our Immunoallergology Department. Rev Port Imunoalergologia [online]. 2012, vol.20, n.4, pp.263-271. ISSN 0871-9721.

Background: Omalizumab is a monoclonal antibody approved as add -on therapy for treatment of severe allergic asthma. We evaluated the clinical response to omalizumab in “real -life” patients with uncontrolled severe allergic asthma. Methods: Retrospective analysis of clinical processes of patients with asthma treated with omalizumab for at least 16 weeks, in our Immunoallergology Department from April 2008 to December 2011. Included patients with severe allergic asthma, not controlled with high dose inhaled corticosteroids (IC) and long acting beta 2 agonists (LABA), which received omalizumab as add -on therapy. The following parameters were analyzed before, 16 weeks and 6 months after initiation of omalizumab: frequency and severity of exacerbations, frequency of rescue medication use, daily medication, daily dose of oral corticosteroids (OC), asthma control by Asthma Control Test(ACT) and value of predicted forced expiratory volume in one second (FEV1). Results: Included 23 patients (8 -72 years, 17 female) with FEV1 <80% of normal predicted, daily symptoms or frequent awakenings and at least one asthma exacerbation requiring OC 16 weeks before the treatment of omalizumab was initiated. All patients discontinued OC (as daily or rescue medication) after 2 months of treatment. At 16 weeks of treatment, all patients reported better control of asthma (average ACT before / after omalizumab: 15/22), reduction of daily medication (decrease in average daily dose of budesonide or equivalent of 1057 μg to 669 μg) and of rescue medication, decrease in number and severity of exacerbations, without severe exacerbations. There was an increase in FEV1 in 18/23 patients (78%). At 6 months of therapy, clinical improvement of the patients remained stable. Discussion: Omalizumab seems to be effective as add -on therapy, in patients with uncontrolled severe allergic asthma despite high dose of IC and LABA. Besides clinical improvement, omalizumab allowed suspension of OC in a short period of time

Keywords : Anti-immunoglobulin E; omalizumab; severe allergic asthma.

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