Abstract
Background: Asthma is a chronic inflammatory condition well controlled with inhaled therapies. In a small cohort of severe cases there remain a clinical unmet need. Omalizumab is licensed as add-on therapy in severe atopic (IgE-mediated) asthma.
Aim: Prospective review of whether treatment with omalizumab over 52 weeks attenuates blood eosinophilia. Secondary endpoints included subjective, objective and healthcare utilisation parameters in the same individuals.
Methods: Patients initiated as per NICE guidance on omalizumab therapy were observed and data collected including blood tests (blood eosinophils), subjective (ACT and AQLQ) and health care utilization (critical care and hospital admission days, oral corticosteroid courses and dose alterations) at the 3 timepoints of 52-weeks pre-omalizumab (baseline), 16-week and 52-week post-omalizumab.
Result: Nine (3M;6F) patients with a mean age of 48 (±12) years were observed. Median baseline eosinophilia was 0.15x10^9/L (IQR 0.02, 0.21), and 0.2 (IQR 0.21, 0.31) and 0.51 (IQR 0.2, 0.71) at 16- and 52-weeks respectively. The table below shows changes in subjective and healthcare utilization parameters.
Parameters | Pre-Omalizumab | 16 wks post-Omalizumab | 52 wks post-Omalizumab |
ACT score | 9.6 | 18.5 | 19.5 |
AQLQ score | 3.6 | 5.7 | 5.4 |
In-patient Hospital (days) | 14.3 | 0.1 | 1.3 |
ITU (days) | 0.3 | 0 | 0 |
No. of Steroid Courses | 3.1 | 0.5 | 0.7 |
Prednisolone Dose (mg/day) | 5.6 | 1.5 | 0.2 |
Conclusion: Omalizumab treatment over 52 weeks had no impact on blood eosinophil counts but as expected, resulted in improvements on healthcare utilization and subjective parameters. The impact of omalizumab therapy on eosinophilia requires confirmation in larger prospective studies.
- Copyright ©ERS 2015