TY - JOUR T1 - OPURIT: <span class="underline">O</span>malizumab-<span class="underline">p</span>rotected <span class="underline">u</span>ltra <span class="underline">r</span>ush <span class="underline">s</span>pecific <span class="underline">i</span>mmunotherapy in severe asthmatic patients with house dust mite allergy JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p270 AU - Thomas Harr AU - Peter Schmid-Grendelmeier Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p270.abstract N2 - Severe uncontrolled asthma is a contraindication against allergen-specific immunotherapy due to increased risks of side effects and asthma exacerbations. Omalizumab (Xolair®) has been shown to be an effective treatment for patients suffering from severe allergic asthma and to increased safety of allergen SpecificImmunoTherapy SIT. We describe 3 patients (males, 28, 31 and 42years) with severe asthma GINA III-IV and total serum IgE ranging from 181 to 680 IU/ml undergoing a combination of Omalizumab and house dust mite-SIT. House dust mite (HDM) allergy was confirmed by clinical history, positive skin prick tests, elevated specific serum IgE and positive conjunctival challenge tests.In all 3 patients Omalizumab was initiated according to manufacturer's recommendation. After 3 months in all patients asthma improved requiring less inhaled drugs and an improved quality of life. The felt effect of HDM exposure was also reduced but still somehow present. Thus we added an allergen-specific immunotherapy with HDM as the asthma situation was stable now. We opted for an ultra-rush induction regimen with a total of 6 injections over 4 hours and a cumulative dose of 100'000 SQU. Patients were closely monitored. All patients tolerated the ultra rush induction very well. The maintenance regimen of the HDM extract was then injected on a monthly base. Also Omalizumab was continued on the initial dose.Omalizumab may enable induction of allergen-specific immunotherapy with HDM in severe asthma patients otherwise not accessible to this approach. The long term effect of this combined treatment will have to be further evaluated to judge clinical and pharmacoeconomical aspects. ER -